COMPARISON OF LAPAROSCOPIC VERSUS OPEN PYELOPLASTY FOR URETEROPELVIC JUNCTION OBSTRUCTION IN ADULTS: A SYSTEMATIC REVIEW AND META-ANALYSIS (Atena Editora)

Abstract

Introduction: There are several surgical treatment options that are available for the treatment of ureteropelvic junction obstruction (UPJO), however results in the adult population are limited. Objectives: To compare clinical outcomes (complication rate, operative time and hospital days) between the laparoscopic versus open pyeloplasty for UPJO in adults. Methodology: MEDLINE and EMBASE were searched through July 22, 2021 to include randomized and nonrandomized controlled trials comparing outcomes of patients treated by laparoscopic pyeloplasty (LP) and by open procedure (OP) for UPJO. The effect size (ES) of the PL and PA treatments was extracted from each study to calculate the combined measurements for continuous operating time (OT) and hospital (HT) variables. Data were pooled using a random effects model. Results: The literature search resulted in 997 studies and 4 met the inclusion criteria with a total of 279 patients. There was a significant difference in the OT between the groups with a moderate ES favoring the PA (SMD, 1.54; 95%CI: 1.21, 1.86; I2=96.8%; p=0.000) and for the HT favoring a LP (SMD, -0.89; 95%CI: -1.29, -0.50; I2=96.1%; p=0.000). Regarding complications, there was a significant difference between LP and OP favoring LP (OR, 0.50; 95%CI: 0.27, 0.95; I2=00.0%; p=0.923). There was no difference between the LP and OP groups for the success rate. Conclusion: LP resulted in significantly lower percentage of complications and hospitalization time than OP, but it had no significant impact on the success rate and also presented significantly longer operative time.