Bruce Gao1, Walid Farhat2, Fadi Zu'bi3, Michael Chua3, Mitchell Shiff3, Rusul Al-Kutbi3, Martha Pokarowski3, Jessica Ming4, Justin Kim5, Joana Dos Santos3, Martin Koyle3. 1. Division of Urology, Department of Surgery, University of Toronto, Toronto, Canada. bmgao@ucalgary.ca. 2. Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA. 3. Division of Pediatric Urology, The Hospital for Sick Children, Toronto, Canada. 4. Division of Urology, Department of Surgery, University of New Mexico, Albuquerque, NM, USA. 5. Division of Urology, Department of Surgery, University of Toronto, Toronto, Canada.
Abstract
PURPOSE: Pyeloplasty for ureteropelvic junction obstruction is the gold standard for surgical repair. There are currently no reports outlining optimal suturing technique. This paper compares the effect of suturing technique in dismembered pediatric pyeloplasty (open and laparoscopic) on post-operative outcomes. METHODS: A non-concurrent cohort study assessed different suturing techniques in both open and laparoscopic dismembered pyeloplasty performed two senior urologists at a tertiary referral pediatric center. Cases were stratified according to different suturing techniques for ureteropelvic anastomosis and subgroup analysis was performed according to open or laparoscopic approach. RESULTS: A total of 185 renal units were evaluated. The overall comparative analysis of different anastomotic suturing techniques and clustered analysis according to open and laparoscopic approach showed no significant differences on post-operative complication rate, leakage, stenosis, redo-pyeloplasties, operative time and hospital stay. There was a significant difference between suturing techniques on stent duration, age and weight of the patient. There was no effect of suture type or size on post-operative complication rate, leakage, UPJ stenosis and redo pyeloplasty rates, however, sample sizes were small. CONCLUSION: Suturing technique has no significant effect on the surgical outcomes assessed regardless of open or laparoscopic technique.
PURPOSE: Pyeloplasty for ureteropelvic junction obstruction is the gold standard for surgical repair. There are currently no reports outlining optimal suturing technique. This paper compares the effect of suturing technique in dismembered pediatric pyeloplasty (open and laparoscopic) on post-operative outcomes. METHODS: A non-concurrent cohort study assessed different suturing techniques in both open and laparoscopic dismembered pyeloplasty performed two senior urologists at a tertiary referral pediatric center. Cases were stratified according to different suturing techniques for ureteropelvic anastomosis and subgroup analysis was performed according to open or laparoscopic approach. RESULTS: A total of 185 renal units were evaluated. The overall comparative analysis of different anastomotic suturing techniques and clustered analysis according to open and laparoscopic approach showed no significant differences on post-operative complication rate, leakage, stenosis, redo-pyeloplasties, operative time and hospital stay. There was a significant difference between suturing techniques on stent duration, age and weight of the patient. There was no effect of suture type or size on post-operative complication rate, leakage, UPJ stenosis and redo pyeloplasty rates, however, sample sizes were small. CONCLUSION: Suturing technique has no significant effect on the surgical outcomes assessed regardless of open or laparoscopic technique.