Minimally Invasive versus Open Ureteral Reimplantation in Children: A Systematic Review and Meta-Analysis
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Read the article on pubmed.ncbi.nlm.nih.gov ↗Article · Jun 2023 · 1 min read
In brief
In brief
This meta-analysis of 7,882 pediatric patients demonstrates that minimally invasive ureteral reimplantation offers shorter hospital stays, reduced blood loss, and fewer wound infections compared to open surgery, while maintaining equivalent success rates and complication profiles. The findings support MIS as a safe and effective alternative to traditional open approaches for treating vesicoureteral reflux in children.
Written by the GCMD Library team from the article.
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 < 0.001), less blood loss (I 2 = 100%, WMD -12.65, 95% CI -24.82 to -0.48; p = 0.04), and less wound infection (I 2 = 0%, odds ratio 0.23, 95% CI 0.06-0.78; p = 0.02). However, no significant difference was found in operative time and secondary outcomes such as postoperative UTI, urinary retention, postoperative hematuria, and overall postoperative complications.
Conclusion: MIS is a safe, feasible, and effective surgical procedure in children when compared with OUR. Compared with OUR, MIS has a shorter hospital stay, less blood loss, and less wound infection. Furthermore, MIS is equivalent to OUR in terms of success rate and secondary outcomes such as postoperative UTI, urinary retention, postoperative hematuria, and overall postoperative complications. We conclude that MIS should be considered an acceptable option for pediatric ureteral reimplantation.
DOI: 10.1055/s-0043-1764321