Abstract:
BACKGROUND:Although shown to be safe in infancy, robotic-assisted laparoscopic pyeloplasty (RALP) for ureteropelvic junction obstruction (UPJO) is most commonly performed in older children and adolescents. OBJECTIVE:This study examined a contemporary RALP experience at a single tertiary pediatric center and compared outcomes in infants aged ≤1 year with an older cohort. METHODS AND DESIGN:All RALP procedures were entered into an Institutional Review Board-approved data registry from 2012 to 2016. Patients were retrospectively grouped according to age. The primary outcome was success rate. Secondary outcomes included complications and length of hospital stay. Failure was defined as the need for secondary surgical intervention for UPJO or worsening urinary tract dilation on imaging. Statistical analysis was performed using SPSS version 20. Mann-Whitney U testing was used for comparison. RESULTS:A total of 138 patients underwent RALP during 2012-2016, with a median age of 6 years (IQR 1, 13.25) and a male:female ratio of approximately 2:1. Of these, 34 (24.6%) were aged ≤1 year. Of all patients, 60 (43.5%) presented with a history of prenatal hydronephrosis, and 32% had a crossing vessel causing obstruction. An indwelling stent was placed in antegrade fashion in 71% of cases, and 18% had a percutaneously placed externalized stent. There were six (4%) failures requiring reoperation. Multivariate and comparative analysis demonstrated that the infant cohort utilized less morphine equivalents and more often had a percutaneous stent placed compared to the older cohort. Of the complications that occurred, 60% were minor (Clavien grades 1 and 2) and 40% were Clavien grade 3 in the infant cohort, and 70.1% and 29.9% in the older cohort, respectively. No studied criteria predicted failure in either cohort. CONCLUSION:This study presented one of the largest contemporary series of consecutive pediatric RALPs, and showed an overall success rate of 96%. There were no significant differences in length of hospital stay, and complications or failure rates in infants compared to older children. This study substantiated the ongoing trend towards the adaptation of robotic-assisted surgery for the entire pediatric patient population.
journal_name
J Pediatr Uroljournal_title
Journal of pediatric urologyauthors
Kawal T,Srinivasan AK,Shrivastava D,Chu DI,Van Batavia J,Weiss D,Long C,Shukla ARdoi
10.1016/j.jpurol.2018.04.023subject
Has Abstractpub_date
2018-12-01 00:00:00pages
540.e1-540.e6issue
6eissn
1477-5131issn
1873-4898pii
S1477-5131(18)30215-8journal_volume
14pub_type
杂志文章abstract::Isolated congenital megacystis represents a rare variant of fetal megacystis without other associated anomalies. The etiology is unclear, and various management strategies have been proposed. We report a case of isolated congenital megacystis that resolved over the first year of life with observation alone. Considerat...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2012.07.012
更新日期:2013-02-01 00:00:00
abstract:OBJECTIVE:Our aim was to assess the outcomes of infant robot-assisted laparoscopic (RAL) upper urinary tract reconstruction. MATERIALS AND METHODS:The medical records of all infants who underwent RAL upper urinary tract reconstruction were reviewed. Patients less than 1 year of age at surgery were included. Patient de...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2014.01.029
更新日期:2014-10-01 00:00:00
abstract:INTRODUCTION:Pediatric robot-assisted laparoscopic (RAL) pyeloplasty has become a viable minimally invasive surgical option for ureteropelvic junction obstruction (UPJO) based on its efficacy and safety. However, RAL pyeloplasty in infants can be a challenging procedure because of the smaller working spaces. The use of...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2018.06.010
更新日期:2018-12-01 00:00:00
abstract:OBJECTIVE:To evaluate the correction of different degrees of penile torsion following a ladder step so that simpler steps are used whenever possible. This can avoid the morbidity and complications of complex procedures. PATIENTS AND METHODS:Cases of congenital and acquired penile torsion were repaired on a ladder step...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2014.05.009
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Most patients with intermittent hydronephrosis have preserved differential renal function (DRF), while others already have impaired DRF at diagnosis. We summarized the clinical manifestations of intermittent hydronephrosis to elucidate what may be related to DRF loss. STUDY DESIGN:We retrospec...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2020.04.026
更新日期:2020-08-01 00:00:00
abstract:INTRODUCTION:A urogenital sinus (US) and an anorectal malformation (ARM) are a rare constellation of anomalies, and the optimal surgical approach is unclear. Open and laparoscopic approaches have been described for US and ARM, but no data exist to support robotic assistance in children. CASE:A 20-month-old Amish femal...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2019.08.001
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:Continuous antimicrobial prophylaxis (prophylaxis) is associated with a reduction in recurrent urinary tract infections in children with vesicoureteral reflux. However, adherence to daily medications has been shown to be poor. OBJECTIVE:To determine patient/caregiver factors associated with non-adherence an...
journal_title:Journal of pediatric urology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jpurol.2019.04.019
更新日期:2019-08-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to determine if later toilet training is associated with urge incontinence in children. METHODS:We used a case-control study design to yield level 2 evidence. RESULTS:Initiation of toilet training after 32 months of age was associated with urge incontinence (P=0.02). CONCLUS...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2009.05.012
更新日期:2009-12-01 00:00:00
abstract:INTRODUCTION:Successful surgical therapy for pediatric upper urinary tract calculi (UUTC) minimizes the need for repeat surgical interventions. However, staged procedures, whether planned or unplanned, are sometimes necessary. We assessed predictors of repeat intervention for children with UUTC using a nationwide admin...
journal_title:Journal of pediatric urology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jpurol.2018.02.017
更新日期:2018-06-01 00:00:00
abstract:PURPOSE:There is limited evidence that prophylactic antibiotics prevent surgical site infection in stented, distal hypospadias repair. Our hypothesis is that the use of prophylactic antibiotics does not affect the rate of surgical site infection in this setting. METHODS:We conducted a retrospective study of consecutiv...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2020.11.033
更新日期:2020-11-30 00:00:00
abstract:OBJECTIVE:Renal disorders can cause hypertension, but less is known about the influence of hydronephrosis on blood pressure. Hydronephrosis due to pelvo-ureteric junction obstruction (PUJO) is a fairly common condition (incidence in newborns of 0.5-1%). Although hypertensive effects of hydronephrosis have been suggeste...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2015.01.008
更新日期:2015-04-01 00:00:00
abstract:BACKGROUND:Posterior urethral valves (PUVs) are one of the leading causes of pediatric chronic kidney disease (CKD). Growth impairment is prevalent in pediatric CKD, and children with PUVs are at high risk for growth retardation. OBJECTIVE:The objective of this study was to describe growth profiles in PUVs and to iden...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2019.03.001
更新日期:2019-05-01 00:00:00
abstract:INTRODUCTION:Urethral injuries and trauma-related strictures (UITSs) in children are rare. The treatment is challenging but crucial to avoid life-long urinary complications such as recurrent stricture formation, urinary incontinence, and impotence. OBJECTIVE:The aim was to report on the surgical and functional outcome...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2018.11.014
更新日期:2019-04-01 00:00:00
abstract::This is the first report of a single trocar nephrectomy for poorly functioning dysplastic kidney and ectopic ureter, performed in 5 patients from 2010 to 2011. The mean operative time was 63 min and mean postoperative hospital stay was 31 h. There were no perioperative complications. The single trocar nephrectomy is a...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2012.10.007
更新日期:2013-08-01 00:00:00
abstract::We describe a novel 'pubic osteotomy minimal' (POM) done on body of pubis just lateral to the insertions of rectus abdominis and adductor longus muscles to bring rectus abdominis in midline without tension for abdominal wall closure without tension. In one patient, during pubic ramotomy, we missed middle of ramus and ...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2020.05.003
更新日期:2020-06-01 00:00:00
abstract:OBJECTIVE:To study the factors that may influence the effectiveness of 0.2% betamethasone/hyaluronidase cream in the treatment of phimosis. METHODS:We treated 427 patients (3-10 years old, mean 6.33) in a prospective, randomized, blind study, with 214 patients on a 4-week and 213 patients on an 8-week course. All pati...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2006.05.006
更新日期:2006-08-01 00:00:00
abstract:INTRODUCTION:Cloacal exstrophy (CE) is the most severe manifestation of the epispadias-exstrophy spectrum. Previous studies have indicated an increased rate of renal anomalies in children with classic bladder exstrophy (CBE). Given the increased severity of the CE defect, it was hypothesized that there would be an even...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2016.04.008
更新日期:2016-08-01 00:00:00
abstract:INTRODUCTION:Stomal stenosis is the most common complication after the creation of a continent catheterizable channel (CCC), but is challenging to treat. OBJECTIVE:To describe early experience with triamcinolone injection for the treatment of stomal stenosis. MATERIALS AND METHODS:A retrospective review was performed...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2017.06.007
更新日期:2017-08-01 00:00:00
abstract:INTRODUCTION:Preoperative hormonal stimulation (PHS) is commonly administered to improve hypospadias outcomes. However, current literature provides no clear evidence to support its use, and controversies exist regarding its effect on postoperative complications. Herein we systematically evaluate the effect of PHS on po...
journal_title:Journal of pediatric urology
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.jpurol.2017.06.019
更新日期:2017-10-01 00:00:00
abstract:OBJECTIVES:To undertake a baseline audit of our pediatric urodynamic service, identifying areas for improvement, and to determine whether clinical management was affected by urodynamic results. PATIENTS AND METHODS:All pediatric urodynamic studies during one calendar year were reviewed to determine the quality of repo...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2004.11.004
更新日期:2005-02-01 00:00:00
abstract:OBJECTIVES:It has been suggested that infants with dilating vesicoureteral reflux (VUR) often have lower urinary tract (LUT) dysfunction. Signs such as high voiding pressure levels, low bladder capacity and dyscoordination at voiding have previously been thought to be indicative of dysfunction. However, these findings ...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2014.08.010
更新日期:2015-02-01 00:00:00
abstract:OBJECTIVE:We present our experience of management of high-grade renal trauma in a pediatric population, including assessment of the long-term function and morphology of the ipsilateral kidney. PATIENTS AND METHODS:From 1997 to 2005, 40 children with high-grade renal injury (III, IV, V) after blunt abdominal trauma wer...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2006.07.006
更新日期:2007-06-01 00:00:00
abstract:OBJECTIVE:Faecal incontinence secondary to myelomeningocele, Hirschsprung disease, and anorectal anomalies remains a significant and common problem. We aimed to report our 5-year experience with the Peristeen trans-anal irrigation system (TAIS) to manage such children. PATIENTS AND METHOD:This study was a combination ...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2013.08.006
更新日期:2014-04-01 00:00:00
abstract:OBJECTIVE:To determine the effectiveness of gabapentin as an add-on therapy in children presenting with overactive bladder (OAB) not responding to conventional anticholinergics. MATERIALS AND METHODS:Children with refractory OAB were included prospectively from March 2009 to February 2010. The inclusion criterion was ...
journal_title:Journal of pediatric urology
pub_type: 临床试验,杂志文章
doi:10.1016/j.jpurol.2011.10.022
更新日期:2013-02-01 00:00:00
abstract:OBJECTIVE:We have previously reported our early experience (2 patients) of single-incision nephrectomy via the retroperitoneal prone route using an advanced access platform (GelPOINT Mini). Here, we review our series to date and also present a detailed video demonstrating the technique. METHOD:In the prone position, a...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2015.04.010
更新日期:2015-10-01 00:00:00
abstract:INTRODUCTION:When patients with neurogenic bladder become refractory, there are different alternatives, such as the use of β3-adreceptor agonists. The aim of the present study is to evaluate efficacy and safety of Mirabegron as adjuvant treatment. MATERIAL AND METHODS:37 patients under 18 years of age who underwent Mi...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2020.07.020
更新日期:2020-10-01 00:00:00
abstract:INTRODUCTION AND OBJECTIVE:Female pediatric patients with continuous drip incontinence present a diagnostic challenge. At times, these symptoms may be due to an ectopic ureter inserting below the external sphincter. The evaluation may consist an ultrasound and voiding cystourethrogram (VCUG), but these may not be diagn...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2005.06.009
更新日期:2007-02-01 00:00:00
abstract:PURPOSE:We aimed to develop a conversion formula between different calculations for testicular volume asymmetry. MATERIALS AND METHODS:Male adolescents with varicoceles who underwent scrotal ultrasound were studied. Two formulas were analyzed: (1) testicular volume differential, TVDiff = (RTV - LTV)/(TTV), and (2) atr...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2013.12.007
更新日期:2014-04-01 00:00:00
abstract:OBJECTIVE:Acquired recto-urethral fistula is an uncommon entity in children and occurs as a consequence of pelvic disorder, including trauma, iatrogenic injury, inflammatory bowel disease, pelvic neoplasm and infection. We have reviewed our experience with treatment of recto-urethral fistula and focussed on the outcome...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2009.03.001
更新日期:2009-12-01 00:00:00
abstract:INTRODUCTION AND OBJECTIVE:Endourological and percutaneous approaches are the standard of care for treatment of pediatric urolithiasis. However, in certain situations, an endoscopic-assisted robotic pyelolithotomy (EARP) can be an acceptable alternative. Limited data exist on pediatric EARP; thus, the authors describe ...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2019.12.007
更新日期:2020-04-01 00:00:00