Zhu Weiwei,Zhou huixia,Li Pin,et al.Comparison of clinical efficacy of robot-assisted laparoscopic Lich-Gregoir procedure and gas-bladder laparoscopic Cohen ureteral reimplantation for primary vesicoureteral reflux[J].Journal of Clinical Pediatric Surgery,,21():437-444.[doi:10.3760/cma.j.cn101785-202109034-008]
Comparison of clinical efficacy of robot-assisted laparoscopic Lich-Gregoir procedure and gas-bladder laparoscopic Cohen ureteral reimplantation for primary vesicoureteral reflux
- Keywords:
- Vesicoureteral Reflux; Robotic Surgical Procedures; Laparoscopy; Treatment Outcome; Comparative Study
- Abstract:
- Objective To compare the clinical efficacy of robot-assisted laparoscopic procedure versus gas-bladder laparoscopic Cohen ureteral reimplantation for vesicoureteral reflux. Methods From June 2016 to June 2020,87 children of primary vesicoureteral reflux (VUR) were recruited. According to the presence of bilat- eral/unilateral VUR, they were divided into unilateral and bilateral groups. And bilateral/unilateral VUR groups were further assigned into two groups of unilateral/bilateral robotic (n=25;n=22) and unilateral/bilateral gas- bladder laparoscopic Cohen ureteral reimplantation (n=22;n=18). The relevant clinical data were analyzed, in- cluding preoperative preparation time, intraperitoneal operative duration, intraoperative blood loss, length of ureter- al catheterization and postoperative hospital stay. Postoperative follow-ups were conducted. Results All opera- tions were successful without any conversion. In unilateral VUR children, preoperative preparation time of robotic and gas-bladder groups was (15. 3 ±2. 9) vs. (28. 8 ±4. 0) min, intraperitoneal operative duration (34. 9 ±3. 0) vs. (46. 7 ±8. 9) min, length of ureteral catheterization 4(3,4) vs. 4(3,5) days, intraoperative blood loss (14. 7 ±2. 7) vs. (16. 8 ±2. 8) ml and postoperative hospital stay (8. 8 ±2. 1) vs. (10. 5 ±2. 8) days respectively. In bi- lateral VUR children, preoperative preparation time of robotic and gas-bladder groups was (16. 5 ±3. 6) vs. (20. 0 ±2. 9) min, intraperitoneal operative duration (81. 6 ±8. 1) vs. (95. 9 ±7. 9) min, length of ureteral cath- eterization 4(3,5) vs. 4(3,5) days, intraoperative blood loss (36. 4 ±7. 0) vs. (34. 4 ±6. 0) ml and postopera- tive hospital stay 7. 5(7, 9) vs. 9 (7. 8, 10) days respectively. Among unilateral/bilateral children, preoperative preparation time, intraperitoneal operative duration and postoperative hospital stay showed significant statistical differences between robotic and gas-bladder groups. No statistical differences in intraoperative blood loss or length of ureteral catheterization existed between robotic and gas-bladder groups. There was no high-grade postoperative complication. Conclusion Both mini-invasive ureteral replantations offer definite curative effects. As compared with gas-bladder Cohen laparoscopy, robot-assisted laparoscopic Lich-Gregoir ureteral replantation has a shorter operative duration and recovers faster postoperatively. However, further clinical studies are required.
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Memo
收稿日期:2021-9-13。
基金项目:首都临床特色应用研究（Z181100001718008）；军队计生课题（18JS001）；首都卫生发展科研专项（2016-2-5091）；卫生部行业科研专项（201402007）
通讯作者:周辉霞,Email:huixia99999@163.com