TÇCD 2024 41st Annual Congress of Turkish Pediatric Surgical Association Congress

M Azizoğlu*, M Gazzaneo**, S Klyuev***, O Aubert****, G Gerçel*****, S Perez Bertolez******, V Alonso*******, TM Orbay********, M Escolino*********, C Esposito*********

*Istanbul Esenyurt Hospital, Department of Pediatric Surgery, Istanbul. Istinye University Department of Stem Cell and Tissue Engineering, Istanbul. Pediatric Surgery Meta Analysis Study Group (PESMA)
**UO Chirurgia Pediatrica, ASST Spedali Civili di Brescia, Università di Brescia, Italia. Specialist Neonatal and Paediatric Surgery, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK. Pediatric Surgery Meta Analysis Study Grou
***AO GK "MEDSI", Department of Pediatric Surgery, Moscow, Russia Federation. Pediatric Surgery Meta Analysis Group (PESMA), Istanbul, Turkey
****Department of Pediatric Surgery, University Hospital Leipzig, Leipzig, Germany. Pediatric Surgery Meta-Analysis Study Group (PESMA)
*****Istanbul Medeniyet University Göztepe Training and Research Hospital, Department of Pediatric Surgery. Pediatric Surgery Meta Analysis Study Group (PESMA)
******Pediatric Surgery Departament. Hospital Sant Joan de Déu. Barcelona. Spain. Pediatric Surgery Meta Analysis Study Group (PESMA)
*******Hospital Universitario de Burgos, Department of Pediatric Surgery, Spain. Pediatric Surgery Meta Analysis Study Group (PESMA)
********Bursa Uludag University, Faculty of Medicine, Department of Pediatric Surgery, Division of Pediatric Urology. Pediatric Surgery Meta Analysis Study Group (PESMA)
*********Division of Pediatric Surgery, Federico II University Hospital, Naples, Italy; Pediatric Surgery Meta Analysis Study Group (PESMA)

Aim: Our aim was to compare the outcomes and success rates of minimally invasive pyeloplasty (MIP), including both laparoscopic and robotic-assisted laparoscopic pyeloplasty, with open pyeloplasty (OP) in infants.

Methods: We performed an English literature review using EMBASE, PubMed, Medline, SCOPUS, Web of Science, and Cochrane databases, encompassing all relevant publications up to August 2024. Patient age, gender, operative time, hospital stay duration, complication rate, success rate, and reoperation rate were evaluated. The impact of minimally invasive procedures on patients with ureteropelvic junction obstruction (UPJO) was investigated using RevMan 5.2 software.

Results: No significant difference in age was found between the MIP and OP groups (p>0.05). The operative time was longer in the MIP group (p<0.05). The hospital stay was shorter in the MIP group (p<0.05). No significant differences were observed between the MIP and OP groups regarding overall complication rates, success rates, or reoperation rates (p>0.05 for each comparison).

Conclusions: MIP is a safe technique for the treatment of UPJO in infants. MIP in infants offers a shorter hospital stay compared to OP, although it requires a longer operative time. There were no significant differences between MIP and OP in terms of overall complication rates, success rates, or reoperation rates, indicating comparable efficacy between the two approaches. Longer follow-up randomized clinical trials are needed to combine these results with more robust scientific evidence.

M Azizoğlu*, M Gazzaneo**, S Klyuev***, O Aubert****, G Gerçel*****, S Perez Bertolez******, V Alonso*******, TM Orbay********, M Escolino*********, C Esposito*********

*Istanbul Esenyurt Hospital, Department of Pediatric Surgery, Istanbul. Istinye University Department of Stem Cell and Tissue Engineering, Istanbul. Pediatric Surgery Meta Analysis Study Group (PESMA)
**UO Chirurgia Pediatrica, ASST Spedali Civili di Brescia, Università di Brescia, Italia. Specialist Neonatal and Paediatric Surgery, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK. Pediatric Surgery Meta Analysis Study Grou
***AO GK
****Department of Pediatric Surgery, University Hospital Leipzig, Leipzig, Germany. Pediatric Surgery Meta-Analysis Study Group (PESMA)
*****Istanbul Medeniyet University Göztepe Training and Research Hospital, Department of Pediatric Surgery. Pediatric Surgery Meta Analysis Study Group (PESMA)
******Pediatric Surgery Departament. Hospital Sant Joan de Déu. Barcelona. Spain. Pediatric Surgery Meta Analysis Study Group (PESMA)
*******Hospital Universitario de Burgos, Department of Pediatric Surgery, Spain. Pediatric Surgery Meta Analysis Study Group (PESMA)
********Bursa Uludag University, Faculty of Medicine, Department of Pediatric Surgery, Division of Pediatric Urology. Pediatric Surgery Meta Analysis Study Group (PESMA)
*********Division of Pediatric Surgery, Federico II University Hospital, Naples, Italy; Pediatric Surgery Meta Analysis Study Group (PESMA)

Amaç

Amacımız, minimal invaziv piyeloplasti (MIP) yönteminin, hem laparoskopik hem de robotik destekli laparoskopik piyeloplasti dahil olmak üzere, bebeklerde açık piyeloplasti (OP) ile karşılaştırıldığında sonuçlarını ve başarı oranlarını değerlendirmekti.

Yöntem

EMBASE, PubMed, Medline, SCOPUS, Web of Science ve Cochrane veritabanlarını kullanarak Ağustos 2024'e kadar olan tüm ilgili yayınları kapsayan bir İngilizce literatür taraması gerçekleştirdik. Hastaların yaşı, cinsiyeti, ameliyat süresi, hastanede kalış süresi, komplikasyon oranı, başarı oranı ve yeniden ameliyat oranı değerlendirildi. Üreteropelvik bileşke obstrüksiyonu (UPJO) olan hastalar üzerinde minimal invaziv işlemlerin etkisi RevMan 5.2 yazılımı kullanılarak araştırıldı.

Bulgular

MIP ve OP grupları arasında yaş açısından anlamlı bir fark bulunmadı (p>0.05). MIP grubunda ameliyat süresi daha uzun bulundu (p<0.05). MIP grubunda hastanede kalış süresi daha kısa bulundu (p<0.05). MIP ve OP grupları arasında genel komplikasyon oranları, başarı oranları veya yeniden ameliyat oranları açısından anlamlı fark gözlemlenmedi (her bir karşılaştırma için p>0.05).

Sonuç

MIP, bebeklerde UPJO tedavisi için güvenli bir tekniktir. MIP, daha uzun bir ameliyat süresi gerektirmesine rağmen, bebeklerde OP'ye kıyasla daha kısa bir hastanede kalış süresi sunar. MIP ve OP arasında genel komplikasyon oranları, başarı oranları veya yeniden ameliyat oranları açısından anlamlı bir fark yoktur, bu da her iki yaklaşımın benzer etkinliğe sahip olduğunu göstermektedir. Bu sonuçları daha sağlam bilimsel kanıtlarla desteklemek için daha uzun takip süreli randomize klinik çalışmalara ihtiyaç vardır.