Meta-analysis of transperitoneal versus retroperitoneal approaches of laparoscopic pyeloplasty for ureteropelvic junction obstruction

To compare transperitoneal and retroperitoneal approaches of laparoscopic pyeloplasty (LP) for ureteropelvic junction obstruction (UPJO) with meta-analysis. All randomized controlled trials (RCTs) and controlled clinical trials (CCTs) comparing transperitoneal LP (TLP) and retroperitoneal LP (RLP) were included systematically using Medline, Embase, and The Cochrane Library. Outcomes were success rate, complications, operative time, conversion, presence of a crossing vessel, and length of hospital stay. Two reviewers independently extracted data and assessed quality. Meta-analysis used both fixed and random effects models with dichotomous data reported as relative risk and continuous data as a weighted mean difference with 95% confidence intervals. One RCT and eight CCTs were identified (reporting 776 participants). Meta-analysis showed that TLP was associated with an operative time reduction of about 40 minutes (weighted mean difference -43.85, 95% confidence interval -58.06 to -27.63; P