One-Trocar–Assisted Pyeloplasty in Children: An 8-Year Single Institution Experience

Ruggeri, Giovanni; Messina, Paolo; Tursini, Stefano; Destro, Francesca; Mogiatti, Mirella; Lima, Mario

doi:10.1055/s-0034-1372459

Cited by 8 publications

(6 citation statements)

References 23 publications

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“…We have already demonstrated this technique to be feasible in terms of efficacy and safety in the first 90 days of life [10]. OTAP puts together the advantages of minimally invasive surgery and traditional dismembered pyeloplasty by Anderson-Hynes, and is therefore an excellent option for treating this category of patients [8,9].…”

Section: Discussionmentioning

confidence: 99%

“…Since 2005, in our institution, the preferred approach for hydronephrosis in children younger than 2 years has been the one-trocar-assisted pyeloplasty (OTAP) [8,9]. This procedure combines the advantages of a minimally invasive technique with the high success rate of standard dismembered pyeloplasty; it had already been proven to be a feasible technique in terms of efficacy and safety in patients treated in the first 90 days of life [10].…”

Section: Introductionmentioning

confidence: 99%

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Uretero-Pelvic Junction Stenosis: Considerations on the Appropriate Timing of Correction Based on an Infant Population Treated with a Minimally-Invasive Technique

Lima¹,

Salvo²,

Portoraro³

et al. 2021

Children

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There is no univocal consensus about timing of intervention and best surgical approach for infants with asymptomatic uretero-pelvic junction obstruction (UPJO). We conducted a retrospective analysis of patients undergoing one-trocar-assisted pyeloplasty (OTAP) in a 13 year range period by creating two homogenous groups (indications for surgery were the same for all patients): patients operated on in the first 90 days of life (34 patients; Group 1) and patients operated on between 3 and 12 months of life (34 patients; Group 2). We observed no statistically significant differences between groups in regard to mean operative time, conversion rate to open surgery, mean hospital stay, early complications (urinary leakage) rate and mean antero-posterior diameter (APD) reduction rate. Moreover, no statistical improvement was seen between groups in regard to separate renal function (SRF) at 1-year-follow-up renogram. Thanks to the HSS calculated before and 1 year after surgery, we registered an important improvement in Group I patients (p = 0.023). In our study, there was no significant evidence, in terms of intraoperative data and early postoperative outcomes, between patients who underwent an early pyeloplasty and those who underwent a delayed correction. Nevertheless, we registered a significant improvement in those patients with an impaired SRF that underwent an early surgical correction, especially in terms of urinary flow. Even though this study cannot definitely establish the superiority of early timing of correction, it is evident that further research is needed to clarify this aspect.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Uretero-Pelvic Junction Stenosis: Considerations on the Appropriate Timing of Correction Based on an Infant Population Treated with a Minimally-Invasive Technique

Lima¹,

Salvo²,

Portoraro³

et al. 2021

Children

Self Cite

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“…discussed the results of this technique in a retrospective review of 88 patients; they concluded that OTAP was safe, feasible and efficacious, with a success and complication rate similar to the open technique. [ 15 ] In 2010, Caione et al . reported a comparative study between open and one trocar retroperitoneal-assisted pyeloplasty.…”

Section: Discussionmentioning

confidence: 99%

One-trocar-assisted pyeloplasty: An attractive alternative to open pyeloplasty

Marte

Papparella

2015

Afr J Paediatr Surg

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Background:To survey the effects of one-trocar-assisted pyeloplasty (OTAP) in the treatment of ureteropelvic junction obstruction (UPJO) in kids.Materials and Methods:Forty-four children (±3.5 years) were submitted to OTAP procedure. A flank incision under the XII rib was made, the Gerota's fascia was achieved and a balloon Hasson trocar with an operative telescope inserted for retroperitoneal access. The renal pelvis and ureter were isolated and exteriorised. Forty-two patients underwent Anderson-Hynes dismembered and one Fenger pyeloplasty. One patient was converted to an open procedure. Two patients presented an aberrant crossing vessel. In all patients, a double J stent was positioned. The operative time and length of stay (LOS) were evaluated. Renal scan and ultrasound (US) were utilised to evaluate the results from 6 to 12 months.Results:OTAP was successful in all but 1 patient. Mean operative time and LOS were 128 min and 3,5 days. We had four operative complications (9.09%). The US and a nuclear scan confirmed the resolution of the UPJO in all patients except one with the Fenger pyeloplasty who had an open Anderson-Hynes.Conclusions:The combination of retroperitoneoscopic and open procedures for dismembered pyeloplasty offers a simple, time-saving method in a minimally invasive fashion with low morbidity for patients with UPJO.

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“…In addition, other surgical techniques needed to be mentioned since they have been investigated in a similar setting with favorable outcomes and in particular one-trocar-assisted pyeloplasty (OTAP) and open pyeloplasty via mini-flank incision (9,10). Which are the patient-related benefits provided by RALP over these approaches?…”

Section: A Commentary Onmentioning

confidence: 99%

Commentary: Early Robotic-Assisted Laparoscopic Pyeloplasty for Infants Under 3 Months With Severe Ureteropelvic Junction Obstruction

2021

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One-Trocar–Assisted Pyeloplasty in Children: An 8-Year Single Institution Experience

Abstract: OTAP is safe, feasible, and efficacious. Operative times are similar or even shorter than those of other minimally invasive techniques and complication rate agrees with the findings of literature. OTAP can be considered a reasonable alternative.

Cited by 8 publications

References 23 publications

Uretero-Pelvic Junction Stenosis: Considerations on the Appropriate Timing of Correction Based on an Infant Population Treated with a Minimally-Invasive Technique

Uretero-Pelvic Junction Stenosis: Considerations on the Appropriate Timing of Correction Based on an Infant Population Treated with a Minimally-Invasive Technique

One-trocar-assisted pyeloplasty: An attractive alternative to open pyeloplasty

Commentary: Early Robotic-Assisted Laparoscopic Pyeloplasty for Infants Under 3 Months With Severe Ureteropelvic Junction Obstruction

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