Factors that impact the outcome of minimally invasive pyeloplasty

Results of the multi-institutional laparoscopic and robotic pyeloplasty collaborative group

Steven M. Lucas, Chandru P. Sundaram, J. Stuart Wolf, Raymond J. Leveillee, Vincent G. Bird, Mohamed Aziz, Stephen E. Pautler, Patrick Luke, Peter Erdeljan, D. Duane Baldwin, Kamyar Ebrahimi, Robert B. Nadler, David Rebuck, Raju Thomas, Benjamin R. Lee, Ugur Boylu, Robert S. Figenshau, Ravi Munver, Timothy D. Averch, Bishoy Gayed & 9 others Arieh L. Shalhav, Mohan S. Gundeti, Erik P Castle, J. Kyle Anderson, Branden G. Duffey, Jaime Landman, Zhamshid Okhunov, Carson Wong, Kurt H. Strom

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

We compared laparoscopic and robotic pyeloplasty to identify factors associated with procedural efficacy. We conducted a retrospective multicenter trial incorporating 865 cases from 15 centers. We collected perioperative data including anatomical and procedural factors. Failure was defined subjectively as pain that was unchanged or worse per medical records after surgery. Radiographic failure was defined as unchanged or worsening drainage on renal scans or worsening hydronephrosis on computerized tomography. Bivariate analyses were performed on all outcomes and multivariate analysis was used to assess factors associated with decreased freedom from secondary procedures. Of the cases 759 (274 laparoscopic pyeloplasties with a mean followup of 15 months and 465 robotic pyeloplasties with a mean followup of 11 months, p <0.001) had sufficient data. Laparoscopic pyeloplasty, previous endopyelotomy and intraoperative crossing vessels were associated with decreased freedom from secondary procedures on bivariate analysis, with a 2-year freedom from secondary procedures of 87% for laparoscopic pyeloplasty vs 95% for robotic pyeloplasty, 81% vs 93% for patients with vs without previous endopyelotomy and 88% vs 95% for patients with vs without intraoperative crossing vessels, respectively. However, on multivariate analysis only previous endopyelotomy (HR 4.35) and intraoperative crossing vessels (HR 2.73) significantly impacted freedom from secondary procedures. Laparoscopic and robotic pyeloplasty are highly effective in treating ureteropelvic junction obstruction. There was no difference in their abilities to render the patient free from secondary procedures on multivariate analysis. Previous endopyelotomy and intraoperative crossing vessels reduced freedom from secondary procedures.

Original languageEnglish (US)
Pages (from-to)522-527
Number of pages6
JournalJournal of Urology
Volume187
Issue number2
DOIs
StatePublished - Feb 2012

Fingerprint

Robotics
Multivariate Analysis
Aptitude
Hydronephrosis
Multicenter Studies
Medical Records
Drainage
Tomography
Kidney
Pain

Keywords

  • laparoscopy
  • reconstructive surgical procedures
  • robotics
  • survival analysis

ASJC Scopus subject areas

  • Urology

Cite this

Factors that impact the outcome of minimally invasive pyeloplasty : Results of the multi-institutional laparoscopic and robotic pyeloplasty collaborative group. / Lucas, Steven M.; Sundaram, Chandru P.; Wolf, J. Stuart; Leveillee, Raymond J.; Bird, Vincent G.; Aziz, Mohamed; Pautler, Stephen E.; Luke, Patrick; Erdeljan, Peter; Baldwin, D. Duane; Ebrahimi, Kamyar; Nadler, Robert B.; Rebuck, David; Thomas, Raju; Lee, Benjamin R.; Boylu, Ugur; Figenshau, Robert S.; Munver, Ravi; Averch, Timothy D.; Gayed, Bishoy; Shalhav, Arieh L.; Gundeti, Mohan S.; Castle, Erik P; Anderson, J. Kyle; Duffey, Branden G.; Landman, Jaime; Okhunov, Zhamshid; Wong, Carson; Strom, Kurt H.

In: Journal of Urology, Vol. 187, No. 2, 02.2012, p. 522-527.

Research output: Contribution to journalArticle

Lucas, SM, Sundaram, CP, Wolf, JS, Leveillee, RJ, Bird, VG, Aziz, M, Pautler, SE, Luke, P, Erdeljan, P, Baldwin, DD, Ebrahimi, K, Nadler, RB, Rebuck, D, Thomas, R, Lee, BR, Boylu, U, Figenshau, RS, Munver, R, Averch, TD, Gayed, B, Shalhav, AL, Gundeti, MS, Castle, EP, Anderson, JK, Duffey, BG, Landman, J, Okhunov, Z, Wong, C & Strom, KH 2012, 'Factors that impact the outcome of minimally invasive pyeloplasty: Results of the multi-institutional laparoscopic and robotic pyeloplasty collaborative group', Journal of Urology, vol. 187, no. 2, pp. 522-527. https://doi.org/10.1016/j.juro.2011.09.158
Lucas, Steven M. ; Sundaram, Chandru P. ; Wolf, J. Stuart ; Leveillee, Raymond J. ; Bird, Vincent G. ; Aziz, Mohamed ; Pautler, Stephen E. ; Luke, Patrick ; Erdeljan, Peter ; Baldwin, D. Duane ; Ebrahimi, Kamyar ; Nadler, Robert B. ; Rebuck, David ; Thomas, Raju ; Lee, Benjamin R. ; Boylu, Ugur ; Figenshau, Robert S. ; Munver, Ravi ; Averch, Timothy D. ; Gayed, Bishoy ; Shalhav, Arieh L. ; Gundeti, Mohan S. ; Castle, Erik P ; Anderson, J. Kyle ; Duffey, Branden G. ; Landman, Jaime ; Okhunov, Zhamshid ; Wong, Carson ; Strom, Kurt H. / Factors that impact the outcome of minimally invasive pyeloplasty : Results of the multi-institutional laparoscopic and robotic pyeloplasty collaborative group. In: Journal of Urology. 2012 ; Vol. 187, No. 2. pp. 522-527.
@article{4fd8a979f722480a9028d948a28a8c35,
title = "Factors that impact the outcome of minimally invasive pyeloplasty: Results of the multi-institutional laparoscopic and robotic pyeloplasty collaborative group",
abstract = "We compared laparoscopic and robotic pyeloplasty to identify factors associated with procedural efficacy. We conducted a retrospective multicenter trial incorporating 865 cases from 15 centers. We collected perioperative data including anatomical and procedural factors. Failure was defined subjectively as pain that was unchanged or worse per medical records after surgery. Radiographic failure was defined as unchanged or worsening drainage on renal scans or worsening hydronephrosis on computerized tomography. Bivariate analyses were performed on all outcomes and multivariate analysis was used to assess factors associated with decreased freedom from secondary procedures. Of the cases 759 (274 laparoscopic pyeloplasties with a mean followup of 15 months and 465 robotic pyeloplasties with a mean followup of 11 months, p <0.001) had sufficient data. Laparoscopic pyeloplasty, previous endopyelotomy and intraoperative crossing vessels were associated with decreased freedom from secondary procedures on bivariate analysis, with a 2-year freedom from secondary procedures of 87{\%} for laparoscopic pyeloplasty vs 95{\%} for robotic pyeloplasty, 81{\%} vs 93{\%} for patients with vs without previous endopyelotomy and 88{\%} vs 95{\%} for patients with vs without intraoperative crossing vessels, respectively. However, on multivariate analysis only previous endopyelotomy (HR 4.35) and intraoperative crossing vessels (HR 2.73) significantly impacted freedom from secondary procedures. Laparoscopic and robotic pyeloplasty are highly effective in treating ureteropelvic junction obstruction. There was no difference in their abilities to render the patient free from secondary procedures on multivariate analysis. Previous endopyelotomy and intraoperative crossing vessels reduced freedom from secondary procedures.",
keywords = "laparoscopy, reconstructive surgical procedures, robotics, survival analysis",
author = "Lucas, {Steven M.} and Sundaram, {Chandru P.} and Wolf, {J. Stuart} and Leveillee, {Raymond J.} and Bird, {Vincent G.} and Mohamed Aziz and Pautler, {Stephen E.} and Patrick Luke and Peter Erdeljan and Baldwin, {D. Duane} and Kamyar Ebrahimi and Nadler, {Robert B.} and David Rebuck and Raju Thomas and Lee, {Benjamin R.} and Ugur Boylu and Figenshau, {Robert S.} and Ravi Munver and Averch, {Timothy D.} and Bishoy Gayed and Shalhav, {Arieh L.} and Gundeti, {Mohan S.} and Castle, {Erik P} and Anderson, {J. Kyle} and Duffey, {Branden G.} and Jaime Landman and Zhamshid Okhunov and Carson Wong and Strom, {Kurt H.}",
year = "2012",
month = "2",
doi = "10.1016/j.juro.2011.09.158",
language = "English (US)",
volume = "187",
pages = "522--527",
journal = "Journal of Urology",
issn = "0022-5347",
publisher = "Elsevier Inc.",
number = "2",

}

TY - JOUR

T1 - Factors that impact the outcome of minimally invasive pyeloplasty

T2 - Results of the multi-institutional laparoscopic and robotic pyeloplasty collaborative group

AU - Lucas, Steven M.

AU - Sundaram, Chandru P.

AU - Wolf, J. Stuart

AU - Leveillee, Raymond J.

AU - Bird, Vincent G.

AU - Aziz, Mohamed

AU - Pautler, Stephen E.

AU - Luke, Patrick

AU - Erdeljan, Peter

AU - Baldwin, D. Duane

AU - Ebrahimi, Kamyar

AU - Nadler, Robert B.

AU - Rebuck, David

AU - Thomas, Raju

AU - Lee, Benjamin R.

AU - Boylu, Ugur

AU - Figenshau, Robert S.

AU - Munver, Ravi

AU - Averch, Timothy D.

AU - Gayed, Bishoy

AU - Shalhav, Arieh L.

AU - Gundeti, Mohan S.

AU - Castle, Erik P

AU - Anderson, J. Kyle

AU - Duffey, Branden G.

AU - Landman, Jaime

AU - Okhunov, Zhamshid

AU - Wong, Carson

AU - Strom, Kurt H.

PY - 2012/2

Y1 - 2012/2

N2 - We compared laparoscopic and robotic pyeloplasty to identify factors associated with procedural efficacy. We conducted a retrospective multicenter trial incorporating 865 cases from 15 centers. We collected perioperative data including anatomical and procedural factors. Failure was defined subjectively as pain that was unchanged or worse per medical records after surgery. Radiographic failure was defined as unchanged or worsening drainage on renal scans or worsening hydronephrosis on computerized tomography. Bivariate analyses were performed on all outcomes and multivariate analysis was used to assess factors associated with decreased freedom from secondary procedures. Of the cases 759 (274 laparoscopic pyeloplasties with a mean followup of 15 months and 465 robotic pyeloplasties with a mean followup of 11 months, p <0.001) had sufficient data. Laparoscopic pyeloplasty, previous endopyelotomy and intraoperative crossing vessels were associated with decreased freedom from secondary procedures on bivariate analysis, with a 2-year freedom from secondary procedures of 87% for laparoscopic pyeloplasty vs 95% for robotic pyeloplasty, 81% vs 93% for patients with vs without previous endopyelotomy and 88% vs 95% for patients with vs without intraoperative crossing vessels, respectively. However, on multivariate analysis only previous endopyelotomy (HR 4.35) and intraoperative crossing vessels (HR 2.73) significantly impacted freedom from secondary procedures. Laparoscopic and robotic pyeloplasty are highly effective in treating ureteropelvic junction obstruction. There was no difference in their abilities to render the patient free from secondary procedures on multivariate analysis. Previous endopyelotomy and intraoperative crossing vessels reduced freedom from secondary procedures.

AB - We compared laparoscopic and robotic pyeloplasty to identify factors associated with procedural efficacy. We conducted a retrospective multicenter trial incorporating 865 cases from 15 centers. We collected perioperative data including anatomical and procedural factors. Failure was defined subjectively as pain that was unchanged or worse per medical records after surgery. Radiographic failure was defined as unchanged or worsening drainage on renal scans or worsening hydronephrosis on computerized tomography. Bivariate analyses were performed on all outcomes and multivariate analysis was used to assess factors associated with decreased freedom from secondary procedures. Of the cases 759 (274 laparoscopic pyeloplasties with a mean followup of 15 months and 465 robotic pyeloplasties with a mean followup of 11 months, p <0.001) had sufficient data. Laparoscopic pyeloplasty, previous endopyelotomy and intraoperative crossing vessels were associated with decreased freedom from secondary procedures on bivariate analysis, with a 2-year freedom from secondary procedures of 87% for laparoscopic pyeloplasty vs 95% for robotic pyeloplasty, 81% vs 93% for patients with vs without previous endopyelotomy and 88% vs 95% for patients with vs without intraoperative crossing vessels, respectively. However, on multivariate analysis only previous endopyelotomy (HR 4.35) and intraoperative crossing vessels (HR 2.73) significantly impacted freedom from secondary procedures. Laparoscopic and robotic pyeloplasty are highly effective in treating ureteropelvic junction obstruction. There was no difference in their abilities to render the patient free from secondary procedures on multivariate analysis. Previous endopyelotomy and intraoperative crossing vessels reduced freedom from secondary procedures.

KW - laparoscopy

KW - reconstructive surgical procedures

KW - robotics

KW - survival analysis

UR - http://www.scopus.com/inward/record.url?scp=84855599785&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84855599785&partnerID=8YFLogxK

U2 - 10.1016/j.juro.2011.09.158

DO - 10.1016/j.juro.2011.09.158

M3 - Article

VL - 187

SP - 522

EP - 527

JO - Journal of Urology

JF - Journal of Urology

SN - 0022-5347

IS - 2

ER -