Liu Huazhang,Ru Wei,Tao Chang,et al.Comparison of robot-assisted laparoscopic Lich-Gregoir procedure vetsus pneumovesical Politano-Leadbetter ureteral reimplantation for treating primary vesicoureteral reflux in infants and young children[J].Journal of Clinical Pediatric Surgery,,():622-627.[doi:10.3760/cma.j.cn101785-202504032-005]
Comparison of robot-assisted laparoscopic Lich-Gregoir procedure vetsus pneumovesical Politano-Leadbetter ureteral reimplantation for treating primary vesicoureteral reflux in infants and young children
- Abstract:
- Objective To compare the clinical efficacy and safety of robot-assisted laparoscopic Lich-Gregoir ureteral reimplantation versus pneumovesical Politano-Leadbetter ureteral reimplantation for the treatment of primary vesicoureteral reflux (VUR) in infants and young children. Methods A retrospective analysis was conducted on the clinical data of 54 infants and young children with primary VUR treated from January 2021 to October 2024.Among them,28 patients underwent robot-assisted Lich-Gregoir surgery (robotic group),and 26 patients underwent pneumovesical Politano-Leadbetter surgery (pneumovesical group).Key indicators including trocar placement time,operative time,duration of postoperative catheterization,length of hospital stay,and postoperative outcomes were compared between the two groups. Results The robotic group had significantly shorter operative time[(95.4±20.6) min vs.(127.1±24.5) min],catheterization time[4.5(4.0,5.8) days vs.6.0(5.0,8.0 ) days],and hospital stay[7.0(6.0,7.8) days vs.8.0(7.0,10.0) days]compared to the pneumovesical group (P<0.05).There was no significant difference in trocar placement time between the two groups[(14.9±3.6) min vs.(16.5±4.6) min,P>0.05].No cases of urinary leakage occurred in the robotic group,whereas two cases occurred in the pneumovesical group (1 resolved with conservative treatment; 1 required ureteral stent and pelvic drain placement).In the robotic group,1 patient developed a urinary tract infection (UTI) one month postoperatively and recovered after conservative treatment; another patient had Grade Ⅰ reflux detected on VCUG at three-month follow-up without symptoms.In the pneumovesical group,two patients developed UTIs that resolved with conservative management; 2 others showed recurrent VUR (1 Grade Ⅰ,1 Grade Ⅱ) without symptoms and were followed up in outpatient clinics.No patient in either group developed ureteral obstruction,required reoperation,or showed worsening of hydronephrosis or ureteral dilation. Conclusions Both minimally invasive approaches are effective for treating primary VUR in infants and young children.Robot-assisted Lich-Gregoir ureteral reimplantation offers the advantages of shorter operative time,faster recovery,and fewer complications,and is a safe and effective minimally invasive surgical option.
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Memo
收稿日期:2025-4-12。
基金项目:浙江省基础公益研究计划(LGF22H050004)
通讯作者:陈光杰,Email:dr.chenguangjie@zju.edu.cn