ArticleTranslational andrology and urology2026
Comparison of outcomes of open, laparoscopic, and robot-assisted laparoscopic pyeloplasty in children with pelviureteric junction obstruction: a systematic review and meta-analysis.
Article in Translational andrology and urology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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14 authors.
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Abstract
Background: Pelviureteric junction obstruction (PUJO) is a leading cause of hydronephrosis in children, and pyeloplasty remains the most frequently performed robot-assisted procedure in this population. This systematic review and meta-analysis aimed to compare outcomes and complication rates across open pyeloplasty (OP), laparoscopic pyeloplasty (LP), and robot-assisted laparoscopic pyeloplasty (RALP). Methods: The PRISMA guidelines were followed. No external funding was received. MEDLINE, PubMed, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched up to February 2026. Studies including ≥10 patients aged <16 years who underwent dismembered pyeloplasty were eligible. Risk of bias (RoB) was assessed using RoB 2, the Newcastle-Ottawa Scale, and JBI tools. Certainty of evidence was evaluated using Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Results: Thirty-eight studies (n=3,159) met the inclusion criteria; 13 were meta-analysed. LP demonstrated longer operative time than OP [mean difference (MD), 21.58 min, 95% confidence interval (CI): 4.28-38.88] (P=0.01). Operative time was comparable between RALP and LP (MD, -1.92 min, 95% CI: -45.75 to 41.72) (P=0.93). LP was associated with shorter hospital stay than OP (MD, -2.33 days, 95% CI: -4.61 to -0.05) (P=0.04). RALP showed reduced length of stay (LOS) compared to LP (MD, -0.89, 95% CI: -1.35 to -0.36) (P=0.0007). Success rates were comparable between OP and LP and between OP and RALP; RALP demonstrated higher success rates when compared to LP [odds ratio (OR) 2.78, 95% CI: 1.09-7.11] (P=0.03). Minor and major complication rates were comparable across all approaches. Certainty of evidence ranged from low to very low across outcomes. Conclusions: All approaches achieve high success with comparable complication profiles. Minimally invasive techniques, particularly RALP, are associated with shorter hospital stay. Higher-quality prospective data are needed.
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