Yang Ping,Li Kangming,Zou Bing,et al.Robotic-assisted laparoscopic pyeloplasty versus laparoscopic pyeloplasty for children with ureteropelvic junction obstruction:Meta-analysis of comparative studies[J].Journal of Clinical Pediatric Surgery,,21():482-489.[doi:10.3760/cma.j.cn101785-202011015-015]
Robotic-assisted laparoscopic pyeloplasty versus laparoscopic pyeloplasty for children with ureteropelvic junction obstruction:Meta-analysis of comparative studies
- Keywords:
- Ureteropelvic Junction Obstruction; Robotic Surgical Procedures; Laparoscopy; Treatment Outcome; Meta-Analysis
- Abstract:
- Objective To systematiclly review the efficacy of robotic-assisted laparoscopic pyeloplasty (RALP) versus laparoscopic pyeloplasty (LP) for children with ureteropelvic junction obstruction (UPJO). Methods A literature search was performed within the databases of PubMed, Cochrane, Web of Science and China National Knowledge Infrastructure (CNKI), VIP and WanFang from the inceptions up to October 2020. Meta-analysis was performed by RevMan 5. 3. Results A total of 12 articles involving 1531 patients were re- trieved. RALP was superior in the following aspects with significant differences:operative success rate[OR=2. 66,95% CI(1. 09,6. 49)], operative duration[MD=-6. 68, 95% CI(-13. 10,-0. 26)], postoperative length of stay[MD=-0. 91,95% CI(-1. 01,-0. 81)] and postoperative complications[OR=0. 49, 95% CI (0. 27,0. 80)]. In descriptive analysis, dosing of analgesic was less in RALP group than that in LP group and the expenditure was higher in RALP group than LP group. Conclusion As compared with LP, RALP has high- er success rate and fewer postoperative complications for UPJO. Operative duration and postoperative length of stay were shorter in the RALP group. However, the expenditure was higher.
References:
[1] 中华医学会泌尿外科学分会小儿泌尿外科学组. 儿童机器人辅助腹腔镜肾盂输尿管连接处梗阻手术操作指南(2020版)[J]. 中华泌尿外科杂志, 2020, 41(7):486-491. DOI:10. 3760/cma. j. cn112330-20200629-00012. Urological Surgery Branch of Chinese Medical Association:Guideline for Robotic-assisted Laparoscopic Pyeloplasty for Uret- eropelvic Junction Obstruction in Children (2020 Edition)[J]. Chinese Journal of Urology, 2020, 41(7):486-491. DOI:10. 3760/cma. j. cn112330-20200629-00012.
[2] Esposito C, Masieri L, Castagnetti M, et al. Robot-assisted vs lap- aroscopic pyeloplasty in children with uretero-pelvic junction ob- struction (UPJO):technical considerations and results[J]. J Pe- diatr Urol, 2019, 15(6):667. e1-e8. DOI:10. 1016/j. jpurol. 2019. 09. 018.
[3] 吕逸清, 谢华, 黄轶晨, 等. 传统腹腔镜与机器人辅助腹腔镜技术在儿童肾盂成形术中的临床应用对比[J]. 中华小儿外科杂志,2019,40(1):41-44. DOI:10. 3760/cma. j. issn. 0253-3006. 2019. 01. 009. Lü YQ, Xie H, Huang YC, et al. Clinical analysis of conventional laparoscopic versus robotic-assisted laparoscopic pyeloplasty in children[J]. Chin J Pediatr Surg,2019,40(1):41-44. DOI:10. 3760/cma. j. issn. 0253-3006. 2019. 01. 009.
[4] Riachy E, Cost NG, Defoor WR, et al. Pediatric standard and ro- bot-assisted laparoscopic pyeloplasty:a comparative single insti- tution study[J]. J Urol,2013,189(1):283-287. DOI:10. 1016/j. juro. 2012. 09. 008.
[5] Casella DP, Fox JA, Schneck FX, et al. Cost analysis of pediatric robot-assisted and laparoscopic pyeloplasty[J]. J Urol,2013,189(3):1083-1086. DOI:10. 1016/j. juro. 2012. 08. 259.
[6] Franco I, Dyer LL, Zelkovic P. Laparoscopic pyeloplasty in the pediatric patient:hand sewn anastomosis versus robotic assisted anastomosis-is there a difference?[J]. J Urol, 2007, 178(4 Pt 1):1483-1486. DOI:10. 1016/j. juro. 2007. 06. 012.
[7] Kovacs RJ, Burris HA 3 rd. WITHDRAWN:Cardio-Oncology:Stronger Together[J]. J Am Coll Cardiol,2019,31:S0735-1097(19) 36086-3. DOI:10. 1016/j. jacc. 2019. 07. 041.
[8] Liu DB, Ellimoottil C, Flum AS, et al. Contemporary national comparison of open, laparoscopic, and robotic-assisted laparo- scopic pediatric pyeloplasty[J]. J Pediatr Urol, 2014, 10(4):610-615. DOI:10. 1016/j. jpurol. 2014. 06. 010.
[9] Riachy E, Defoor WR, Reddy PP, et al. Pediatric laparoscopic py- eloplasty and robotic-assisted laparoscopic pyeloplasty a compara- tive single-institution study[J]. J Urol, 2012, 187(4, Supple- ment):e191-e192. DOI:10. 1016/j. juro. 2012. 02. 536.
[10] Silay MS, Danacioglu O, Ozel K, et al. Laparoscopy versus robotic- assisted pyeloplasty in children:preliminary results of a pilot pro- spective randomized controlled trial[J]. World J Urol, 2020, 38(8):1841-1848. DOI:10. 1007/s00345-019-02910-8.
[11] Silay MS, Spinoit AF, Undre S, et al. Global minimally invasive pyeloplasty study in children:Results from the Pediatric Urology Expert Group of the European Association of Urology Young Aca- demic Urologists working party[J]. JAAD Case Rep, 2016, 12(4):229. e1-e7. DOI:10. 1016/j. jpurol. 2016. 04. 007.
[12] Song SH, Lee C, Jung J, et al. A comparative study of pediatric open pyeloplasty, laparoscopy-assisted extracorporeal pyeloplasty, and robot-assisted laparoscopic pyeloplasty[J]. PLoS One,2017, 12(4):e0175026. DOI:10. 1371/journal. pone. 0175026.
[13] Subotic U, Rohard I, Weber DM, et al. A minimal invasive surgi- cal approach for children of all ages with ureteropelvic junction obstruction[J]. J Pediatr Urol, 2012, 8(4):354-358. DOI:10. 1016/j. jpurol. 2011. 07. 004.
[14] Gettman MT, Neururer R, Bartsch G, et al. Anderson-Hynes dis- membered pyeloplasty performed using the da Vinci robotic sys- tem[J]. Urology,2002,60(3):509-513. DOI:10. 1016/s0090-4295(02) 01761-2.
[15] 周辉霞, 曹华林. 机器人辅助腹腔镜手术在小儿泌尿外科的应用与现状[J]. 中华腔镜外科杂志(电子版),2018,11(2):72-76. DOI:10. 3877/cma. j. issn. 1674-6899. 2018. 02. 003. Zhou HX, Cao HL. Application and current status of robot assisted laparoscopic surgery in pediatric urology[J]. Chin J Laparoscopic Surgery (Electronic Edition), 2018, 11(2):72-76. DOI:10. 3877/cma. J. Issn. 1674-6899. 2018. 02. 003.
[16] 徐哲, 谢钧韬, 高文宗, 等. 达芬奇机器人手术治疗小儿肾积水的初步经验[J]. 中华腔镜泌尿外科杂志(电子版), 2017, 11(3):9-12. DOI:10. 3877/cma. j. issn. 1674-3253. 2017. 03. 003. Xu Z, Xie JT, Gao WZ, et al. Preliminary experiences of treating pediatric hydronephrosis by Da vinci robotic surgery[J]. Chinese Journal of Endourology (Electronic Version), 2017, 11(3):9-12. DOI:10. 3877/cma. j. issn. 1674-3253. 2017. 03. 003.
[17] 吕逸清, 谢华, 黄轶晨, 等. 机器人辅助腹腔镜下儿童肾盂成形术的初步探讨[J]. 中华泌尿外科杂志,2015,36(10):721-725. DOI:10. 3760/cma. j. issn. 1000-6702. 2015. 10. 001. Lü YQ, Xie H, Huang YC, et al. Preliminary results of robotic-as- sisted laparoscopic pyeloplasty in children[J]. Chinese Journal of Urology,2015,36(10):721-725. DOI:10. 3760/cma. j. issn. 1000-6702. 2015. 10. 001.
[18] Andolfi C, Adamic B, Oommen J, et al. Robot-assisted laparoscop- ic pyeloplasty in infants and children:is it superior to convention- al laparoscopy?[J]. World J Urol, 2020, 38(8):1827-1833. DOI:10. 1007/s00345-019-02943-z.
[19] 何大维. 儿童腹腔镜下肾盂输尿管成形术的相关问题[J]. 临床小儿外科杂志,2018, 17(6):409-411, 418. DOI:10. 3969/j. issn. 1671-6353. 2018. 06. 003. He DW. Related problems of laparoscopic pyeloplasty in children[J]. J Clin Ped Sur,2018,17(6):409-411,418. DOI:10. 3969/j. issn. 1671-6353. 2018. 06. 003.
[20] 李宁, 周学锋, 袁继炎, 等. 达芬奇机器人在儿童肾盂成形术中的应用体会——附9 例报告[J]. 临床小儿外科杂志, 2019,18(4):294-298. DOI:10. 3969/j. issn. 1671-6353. 2019. 04. 009. Li N, Zhou XF, Yuan JY, et al. Robot-assisted laparoscopic pyelo- plasty in children:a report of 9 cases[J]. J Clin Ped Sur,2019, 18(4):294-298. DOI:10. 3969/j. issn. 1671-6353. 2019. 04. 009.
[21] Cundy TP, Harling L, Hughes-Hallett A, et al. Meta-analysis of robot-assisted vs conventional laparoscopic and open pyeloplasty in children[J]. BJU Int, 2014, 114(4):582-594. DOI:10. 1111/bju. 12683.
Memo
收稿日期:2020-11-8。
基金项目:四川省医学科研课题计划(S20067)
通讯作者:李康明,Email:son.of.old@foxmail.com