title: Comparative evaluation of the resolution of hydronephrosis in children who underwent open and robotic-assisted laparoscopic pyeloplasty.
abstract: OBJECTIVE
  To assess long-term postoperative ultrasonographic outcomes of robotic-assisted laparoscopic pyeloplasty (RALP) and of conventional open pyeloplasty (COP) in pediatric patients with ureteropelvic junction obstruction.
  
  
  METHODS
  Retrospective review of 312 patients who underwent RALP or COP in a single institution. Preoperative and postoperative ultrasounds were used to determine the grade of hydronephrosis. Postoperative assessment included 3 ultrasounds at 0-6, 6-12 and >12 months intervals. Patients were matched by age, etiology of obstruction, grade of preoperative hydronephrosis and gender for case-matched analysis.
  
  
  RESULTS
  We identified 212 pyeloplasties that met inclusion criteria, being 58 RALP and 154 COP. Groups were different in age, gender and etiology, but similar in severity of hydronephrosis and follow-up time. At the end of follow-up, complete resolution and success rates were 62% and 74% in RALP and 45% and 70% in COP, respectively. Matching included 105 patients. Complete resolution was higher in RALP (p = 0.004), while median time before improvement was lower (12.3 months RALP vs 29.9 months COP). There was no difference in success rate at the end of follow-up between the groups.
  
  
  CONCLUSIONS
  RALP shows satisfactory long-term outcomes, comparable to COP. In our cohort, patients who underwent robotic pyeloplasty showed faster resolution of hydronephrosis on ultrasound.
authors.affiliation: Department of Urology, Hunnewell-353, Children's Hospital Boston, Boston, MA 02115, USA. Joaoarthur.barbosa@childrens.harvard.edu
authors.forename: Joao A
authors.initials: JA
authors.lastname: Barbosa
authors.forename: Alexander
authors.initials: A
authors.lastname: Kowal
authors.forename: Bulent
authors.initials: B
authors.lastname: Onal
authors.forename: Eder
authors.initials: E
authors.lastname: Gouveia
authors.forename: Michele
authors.initials: M
authors.lastname: Walters
authors.forename: Justin
authors.initials: J
authors.lastname: Newcomer
authors.forename: Jeanne
authors.initials: J
authors.lastname: Chow
authors.forename: Hiep T
authors.initials: HT
authors.lastname: Nguyen
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006869:Hydronephrosis / Q000000981:diagnostic imaging / Q000601:surgery*; D007223:Infant; D053208:Kaplan-Meier Estimate; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D012371:Robotics; D016896:Treatment Outcome; D014463:Ultrasonography; D014517:Ureteral Obstruction / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods*