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Surgical approaches for treatment of ureteropelvic junction obstruction - a systematic review and network meta-analysis.


ABSTRACT:

Background

Multiple surgical treatment options are available for the treatment of ureteropelvic junction obstruction (UPJO). The aim of this study is to compare the most frequently used technics in a comprehensive network approach.

Methods

A systematic literature search of the EMBASE, MEDLINE and COCHRANE libraries was conducted in January 2018. Publications were included that evaluated at least two of the following surgical techniques: open pyeloplasty (OP), endopyelotomy (EP), laparoscopic (LP) and robot assisted pyeloplasty (RP). Main outcomes were operative success, complications, urinary leakage, re-operation, transfusion rate, operating time, and length of stay. Network meta-analyses with random effects models simultaneously assessed effectiveness of all surgical techniques.

Results

A total of 26 studies including 3143 patients were analyzed. Compared with RP, EP and LP showed lower operative success rates (EP: OR?=?0.09, 95%CI:0.05-0.19; p ConclusionsMultiple surgical techniques are available for treatment of UPJO. RP has the highest rates of operative success and as well as LP lower complication rates than OP. Although surgical outcomes are worse for EP, its operating time is shorter than OP, RP, and LP. Surgeons should consider these findings when selecting the optimal treatment method for individual patients.

SUBMITTER: Uhlig A 

PROVIDER: S-EPMC6849262 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

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Publications

Surgical approaches for treatment of ureteropelvic junction obstruction - a systematic review and network meta-analysis.

Uhlig Annemarie A   Uhlig Johannes J   Trojan Lutz L   Hinterthaner Marc M   von Hammerstein-Equord Alexander A   Strauss Arne A  

BMC urology 20191111 1


<h4>Background</h4>Multiple surgical treatment options are available for the treatment of ureteropelvic junction obstruction (UPJO). The aim of this study is to compare the most frequently used technics in a comprehensive network approach.<h4>Methods</h4>A systematic literature search of the EMBASE, MEDLINE and COCHRANE libraries was conducted in January 2018. Publications were included that evaluated at least two of the following surgical techniques: open pyeloplasty (OP), endopyelotomy (EP), l  ...[more]

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