{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T21:51:38Z","timestamp":1792533098293,"version":"4.5.0"},"reference-count":13,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2024,8,30]],"date-time":"2024-08-30T00:00:00Z","timestamp":1724976000000},"content-version":"unspecified","delay-in-days":29,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,8,13]]},"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The treatment of children with pelviureteric junction obstruction (PUJO) has naturally progressed from open, to minimally invasive approaches, including laparoscopic pyeloplasty and robot-assisted laparoscopic pyeloplasty (RALP). The RALP is now considered to be the gold standard for paediatric patients with PUJO, except for smaller infants due to size limitations. Our systematic review aims to synthesise all the available evidence regarding key postoperative outcomes for the three surgical approaches to pyeloplasties in children. Our outcomes of interest include, but are not limited to, the reoperation rate, length of hospital stay and postoperative complications as classified by the Clavien-Dindo grading system. A comprehensive assessment of all three methods in paediatric patients has yet to be conducted in the literature to date.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>A systematic search of the MEDLINE, PubMed, EMBASE and Cochrane databases will be conducted. Screening, data extraction, statistical analysis and reporting will be performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Included papers will be full-text manuscripts written between 1947 and March 2024, comparing the outcomes and complications of open, laparoscopic and RALP. Quality and study bias will be assessed using the Newcastle-Ottawa score and, if relevant, the Cochrane risk of bias tool for randomised trials. This present protocol is written in accordance with the PRISMA Protocol 2015 checklist, ensuring that the highest methodological standards are adhered to.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>No ethical approval shall be required, as this is a review of already published literature. Findings will be disseminated through publications in peer-reviewed journals and presentations at international and national conferences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PROSPERO registration number<\/jats:title>\n                    <jats:p>CRD42023456779.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-087519","type":"journal-article","created":{"date-parts":[[2024,8,30]],"date-time":"2024-08-30T12:16:02Z","timestamp":1725020162000},"page":"e087519","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Comparison of outcomes of open, laparoscopic and robot-assisted laparoscopic pyeloplasty in children with ureteropelvic junction obstruction: protocol for a systematic review and meta-analysis"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8427-7223","authenticated-orcid":false,"given":"Panagiotis","family":"Nikolinakos","sequence":"first","affiliation":[{"name":"Department of Urology, West Middlesex University Hospital, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK"},{"name":"Department of Pediatric Surgery, School of Medicine, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolaos","family":"Chatzikrachtis","sequence":"additional","affiliation":[{"name":"Department of Urology, West Middlesex University Hospital, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6835-5900","authenticated-orcid":false,"given":"Abhisekh","family":"Chatterjee","sequence":"additional","affiliation":[{"name":"Department of Medicine, Faculty of Medicine, Imperial College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivo","family":"Donkov","sequence":"additional","affiliation":[{"name":"Department of Urology, West Middlesex University Hospital, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Bishara","sequence":"additional","affiliation":[{"name":"Department of Urology, West Middlesex University Hospital, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisavet","family":"Kotsi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Penteli Children\u2019s Hospital, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioannis","family":"Alexandrou","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Penteli Children\u2019s Hospital, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolaos","family":"Zavras","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, School of Medicine, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph M","family":"Norris","sequence":"additional","affiliation":[{"name":"UCL Division of Surgery and Interventional Science, University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,8,30]]},"reference":[{"key":"2025121601075066000_14.8.e087519.1","first-page":"1544","article-title":"Die Geschichte der operativen Behandlung der Harnleiterabgangsstenose (Pyeloplastik)","volume":"43","author":"Poulakis","year":"2004","journal-title":"Urol"},{"key":"2025121601075066000_14.8.e087519.2","first-page":"573","article-title":"Minimal Invasive Treatment in Pelvic-Ureteric Junction Obstruction: A Comprehensive Review","volume":"13","author":"Wahyudi","year":"2021","journal-title":"Res Rep Urol"},{"key":"2025121601075066000_14.8.e087519.3","doi-asserted-by":"crossref","first-page":"12263","DOI":"10.4081\/aiua.2024.12263","article-title":"Robotic pyeloplasty: Technological global panacea or geo-surgical nightmare?","volume":"96","author":"Nikolinakos","year":"2024","journal-title":"Arch Ital Urol Androl"},{"key":"2025121601075066000_14.8.e087519.4","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.euros.2023.03.004","article-title":"Day Surgery in Children Undergoing Retroperitoneal Robot-assisted Laparoscopic Pyeloplasty: Is It Safe and Feasible?","volume":"51","author":"Broch","year":"2023","journal-title":"Eur Urol Open Sci"},{"key":"2025121601075066000_14.8.e087519.5","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1016\/j.jpurol.2019.09.018","article-title":"Robot-assisted vs laparoscopic pyeloplasty in children with uretero-pelvic junction obstruction (UPJO): technical considerations and results","volume":"15","author":"Esposito","year":"2019","journal-title":"J Pediatr Urol"},{"key":"2025121601075066000_14.8.e087519.6","doi-asserted-by":"crossref","DOI":"10.1186\/2046-4053-4-1","article-title":"Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 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