Minimally Invasive versus Open Ureteral Reimplantation in Children: A Systematic Review and Meta-Analysis

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Purpose We performed a systematic review and meta-analysis to compare the safety and efficacy of minimally invasive surgery (MIS) versus open ureteral reimplantation (OUR) in children. Methods Literature searches were conducted to identify studies that compared MIS (laparoscopic ureteral reimplantation or robot-assisted laparoscopic ureteral replantation) and OUR in children. Parameters such as operative time, blood loss, length of hospital stay, success rate, postoperative urinary tract infection (UTI), urinary retention, postoperative hematuria, wound infection, and overall postoperative complications were pooled and compared by meta-analysis. Results Among the 7,882 pediatric participants in the 14 studies, 852 received MIS, and 7,030 received OUR. When compared with the OUR, the MIS approach resulted in shorter hospital stays (I 2 = 99%, weighted mean difference [WMD] –2.82, 95% confidence interval [CI] –4.22 to –1.41; p

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Article · Mar 2023 · 1 min read

In brief

This systematic review and meta-analysis of 7,882 pediatric patients compares minimally invasive surgical approaches (laparoscopic and robot-assisted) to traditional open ureteral reimplantation. MIS demonstrated shorter hospital stays while maintaining comparable safety and efficacy outcomes, informing surgical decision-making for vesicoureteral reflux management in children.

Minimally invasive ureteral reimplantation reduces hospital stay by ~2.8 days vs open surgery in pediatric patients.
MIS and open approaches show comparable success rates and postoperative UTI rates in children with vesicoureteral reflux.
Operative time is longer for MIS, but blood loss and wound complications are reduced compared to open reimplantation.
Meta-analysis of 7,882 children supports MIS as a safe alternative with faster recovery despite technical complexity.
Postoperative hematuria and urinary retention rates are similar between minimally invasive and open techniques.

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