Liu Qi,Xing Xinrang,Zeng Xiaoxu,et al.A comparative efficacy study of robot-assisted laparoscopy versus conventional laparoscopy for pelvic ureteral junction obstruction in children[J].Journal of Clinical Pediatric Surgery,,22():660-665.[doi:10.3760/cma.j.cn101785-202211037-011]
A comparative efficacy study of robot-assisted laparoscopy versus conventional laparoscopy for pelvic ureteral junction obstruction in children
- Keywords:
- Robotic Surgical Procedures; Laparoscopes; Ureteral Diseases; Surgical Procedures; Operative; Child
- Abstract:
- Objective To explore the efficacy of robot-assisted laparoscopy versus conventional laparoscopy for ureteropelvic junction obsruction (UPJO) in children.Methods Retrospective review was conducted for clinical data of 63 UPJO children from January 2021 to May 2022.Robot-assisted laparoscopic pyeloplasty (RALP, n=31) and conventional laparoscopic pyeloplasty (RALP, n=32) were performed.General profiles such as age, gender, weight and affected side were recorded along with clinical data such as operative duration, estimated intraoperative hemorrhage, postoperative drainage time, postoperative hospital stay and hospitalization expenditure, as well as anterior-posterior diameter of renal pelvis (APD), pelvis-to-parenchyma thickness ratio (pelvis/cortex ratio, PCR) and fractional renal pelvis thickness ratio.PCR, differential renal function (DRF) and other imaging data were analyzed for determining which surgical procedure was more advantageous among UPJO, RALP and LP.Results All procedures were completed successfully and there was no conversion into open surgery.Operative duration in RALP group was comparable to that in LP group[(119.87±15.64) vs.(128.53±36.27) min]and the differences were not statistically significant (P>0.05).When RALP and LP groups were compared, hemorrhagic volume was[5(3-5) vs.5(5-10) mL], postoperative drainage time[5(5-6) vs.6(5-8) day], postoperative hospitalization time[(7.13±1.59) vs.(8.81±3.35) day]and hospitalization expenditure[(45 506.81±1 717.28) vs.(18 854.06±1 575.80) yuan].The differences were statistically significant.The postoperative follow-up period was (5-15) month for both groups.At Month 3 post-operation, APD and PCR were different before and after operation.At Month 6 post-operation, APD and PCR were different before and after operation.The differences were statistically significant (P<0.05).At Month 6 post-operation, APD differed between RALP and LP groups (P<0.05).The inter-group difference in postoperative occurrence of complications was not statistically significant (P>0.05).Conclusion Robot-assisted laparoscopy offers some advantages over conventional laparoscopy in terms of postoperative drainage time and hospital stay in UPJO children.With faster postoperative recovery and excellent application prospects, it may be promoted as a first-line option for UPJO children if expenditure is strictly controlled.
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Memo
收稿日期:2022-11-17。
通讯作者:苏泽礼,Email:suzeli188@sina.com