title: Infant robotic pyeloplasty: comparison with an open cohort.
abstract: OBJECTIVE
  To present our experience with infant pyeloplasty, comparing outcomes between robotic-assisted laparoscopic pyeloplasty (RALP) and open pyeloplasty (OP).
  
  
  METHODS
  A retrospective review was performed of all children <1 year of age who underwent unilateral dismembered pyeloplasty at a single pediatric institution since January 2007. Patients with standard laparoscopic pyeloplasty were excluded. Patient demographics, intraoperative details, narcotic usage, and complications were reviewed.
  
  
  RESULTS
  A total of 70 infants (51 boys and 19 girls) were identified, with nine RALP and 61 OP performed. Median age was 9.2 months (range, 3.7-11.9 months) for RALP and 4.1 months (range, 1.0-11.6 months) for OP (p = 0.005). Median weight was 8 kg (range, 5.8-10.9 kg) for RALP and 7 kg (range, 4-14 kg) for OP (p = 0.163). Median operative time was 115 min (range, 95-205 min) for RALP and 166 min (range, 79-300 min) for OP (p = 0.028). Median hospital stay was 1 day (range, 1-2 days) for RALP and 3 days (range, 1-7 days) for OP (p < 0.001). Median postoperative narcotic use of morphine equivalent was <0.01 mg/kg/day (range, 0-0.1 mg/kg/day) for RALP and 0.05 mg/kg/day (range, 0-2.2 mg/kg/day) for OP (p < 0.001). Median follow-up was 10 months (range, 7.2-17.8 months) for RALP and 43.6 months (3.4-73.8 months) for OP (p < 0.001). The success rate was 100% for RALP and 98% for OP.
  
  
  CONCLUSIONS
  Infant RALP was observed to be feasible and efficacious with shorter operative time, hospital stay, and narcotic utilization than OP.
authors.affiliation: Division of Pediatric Urology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, ML 5037, Cincinnati, OH 45229, USA.
authors.forename: D
authors.initials: D
authors.lastname: Bansal
authors.affiliation: Division of Pediatric Urology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, ML 5037, Cincinnati, OH 45229, USA.
authors.forename: N G
authors.initials: NG
authors.lastname: Cost
authors.affiliation: Division of Pediatric Urology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, ML 5037, Cincinnati, OH 45229, USA.
authors.forename: W R
authors.initials: WR
authors.lastname: DeFoor
authors.affiliation: Division of Pediatric Urology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, ML 5037, Cincinnati, OH 45229, USA.
authors.forename: P P
authors.initials: PP
authors.lastname: Reddy
authors.affiliation: Division of Pediatric Urology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, ML 5037, Cincinnati, OH 45229, USA.
authors.forename: E A
authors.initials: EA
authors.lastname: Minevich
authors.affiliation: Division of Pediatric Urology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, ML 5037, Cincinnati, OH 45229, USA.
authors.forename: B A
authors.initials: BA
authors.lastname: Vanderbrink
authors.affiliation: Division of Pediatric Urology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, ML 5037, Cincinnati, OH 45229, USA.
authors.forename: S
authors.initials: S
authors.lastname: Alam
authors.affiliation: Division of Pediatric Urology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, ML 5037, Cincinnati, OH 45229, USA.
authors.forename: C A
authors.initials: CA
authors.lastname: Sheldon
authors.affiliation: Division of Pediatric Urology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, ML 5037, Cincinnati, OH 45229, USA. Electronic address: paul.noh@cchmc.org.
authors.forename: P H
authors.initials: PH
authors.lastname: Noh
mesh_terms: D000701:Analgesics, Opioid / Q000627:therapeutic use; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006869:Hydronephrosis / Q000000981:diagnostic imaging / Q000601:surgery*; D007223:Infant; D007682:Kidney Pelvis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D007902:Length of Stay; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D061646:Operative Time; D010149:Postoperative Pain / Q000188:drug therapy / Q000503:physiopathology; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D012189:Retrospective Studies; D018570:Risk Assessment; D012371:Robotics; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography; D013520:Urologic Surgical Procedures / Q000379:methods*
chemical_list: D000701:Analgesics, Opioid
keywords: Infant; Pyeloplasty; Robotic; Ureteropelvic junction obstruction