Multicenter comparative study of open, laparoscopic, and robotic pyeloplasty in the pediatric population for the treatment of ureteropelvic junction obstruction (UPJO)

ABSTRACT Introduction: Dismembered open pyeloplasty described by Anderson and Hynes is the "gold standard" for the treatment of ureteropelvic junction obstruction. The aim of our study was to compare the results of open (OP) vs laparoscopic (LP) vs robotic (RALP) pyeloplasty. Material and Methods: A multicenter prospective review was conducted of pyeloplasty surgeries performed at five high-volume centers between 2014 and 2018. Demographic data, history of prenatal hydronephrosis, access type, MAG3 renogram and differential renal function, surgery time, length of hospital stay, and complication rate (Clavien-Dindo) were recorded. Access type was compared using the Kruskal-Wallis, Chi-square, or Fisher's exact tests. Results: A total of 322 patients were included: 62 OP, 86 LP, and 174 RALP. The mean age was 8.13 (r: 1-16) years, with a statistically significant lower age (mean 5 years) in OP (p < 0.001). There were no significant differences in the distribution of the side affected. Operative time was 110.5 min for OP, 140 min for LP, and 179 min for RALP (p < 0.0001). Hospital stay was significantly shorter in the RALP group than in the other groups (p < 0.0001). There were no differences in postoperative complications and reoperations between the three groups. Conclusions: Minimally invasive surgery for the management of UPJO in children is gaining more acceptance, even in patients younger than 1-year-old. Operative time continues to be significantly shorter in OP than in LP and RALP. Hospital stay was shorter in RALP compared to the other techniques. No differences were found in complication rates, type of complications, and reoperation rate.

The effect of the Covid-19 pandemic on pediatric urology

ABSTRACT Medical and surgical priorities have changed dramatically at the time of this pandemic. Scientific societies around the World have provided rapid guidance, underpinned by the best knowledge available, on the adaptation of their guidelines recommendations to the current situation. There are very limited scientific evidence especially in our subspecialty of pediatric urology. We carry out a review of the little scientific evidence based mainly on the few publications available to date and on the recommendations of the main scientific societies regarding which patients should undergo surgery, when surgery should be performed and how patient visits should be organize.

Fístulas urinarias en la práctica urológica / Urinary fistulas in the urological practice

Purpose: to analyze the different aspects of urinary fistulas. Design: retrospective observational clinical study. Methods: we evaluated 50 cases comparing different aspectis as etiology, incidence, diagnosis, treatment and success rate... This study demonstrates the high rate of successful closure of the urinary fistula, but highlight the knowledge that we should have of the incidence, etiology, diagnosis and treatment of this urological problem

Abscesos hepáticos, tratamiento percutáneo / Hepatic abscesses, percutaneous treatment

Objetivo: presentar la casuística de nuestro servicio y mostrar la efectividad del método. Lugar de aplicación: Sector Hígado y Vías Biliares. Servicio de Cirugía General y Torácica. Hospital Francés de Buenos Aires. Diseño: estudio retrospectivo. Población: cinco pacientes con diagnóstico de absceso hepático piógeno entre 23 y 56 años de edad vistos entre marzo de 1996 y marzo de 1998. Método: drenaje percutáneo guiado por TAC y antibioticoterapia temprana combinada con tres drogas. Resultados: curación en el 100 por ciento de los casos, con escasa morbilidad y sin registro de mortalidad. Conclusión: el drenaje percutáneo junto a la antibioticoterapia empírica temprana, es a nuestro criterio, el tratamiento de elección para los abscesos hepáticos piógenos únicos