Jingjing Lu, Guangxu You, Yuru Zhang, Shan Lin, Shaohua He, Jianglong Chen, Di Xu, Huihuang Xu
Our study suggests that while all three robotic approaches achieve similar surgical outcomes for pediatric UPJO. Notably, the single-port technique offers additional advantages in minimizing surgical incisions. However, its potential cosmetic advantages remain to be confirmed through studies incorporating validated cosmetic outcome measures. These findings should be considered preliminary and require validation in larger prospective or multicenter studies.
OBJECTIVE: This study aims to compare the efficacy of single-port, single-port-plus-one, and multi-port robot-assisted laparoscopic pyeloplasty in treating children with ureteropelvic junction obstruction (UPJO).
MATERIALS AND METHODS: We retrospectively analyzed the surgical data of 55 pediatric patients with UPJO who underwent robot-assisted laparoscopic pyeloplasty in our department between October 2022 and October 2024. The cohort was stratified into three groups. Robotic-assisted single-port pyeloplasty (RSPY), Robotic-assisted single-port-plus-one pyeloplasty (RSPY+1), and Robotic-assisted multiport pyeloplasty (RMPY). Demographic, intraoperative (operative time, console time, blood loss, conversion to open surgery), and postoperative (hospital stay, total cost) parameters were assessed to compare the clinical efficacy of the three surgical approaches.
RESULTS: All surgical procedures were successfully completed without conversion to open surgery in any of the three groups. No statistically significant differences were observed among the three groups regarding baseline characteristics-including age, gender, weight, and height, operative data-including total operative time (172.80 ± 13.83 min VS 178.15 ± 32.41 min VS 169.40 ± 12.16 min P > 0.05)、console time (98.00 ± 12.37 min VS 100.08 ± 19.54 min VS 95.98 ± 14.11 min P > 0.05) 、intraoperative blood loss、follow-up data-including Preoperative and postoperative renal cortical thickness,antero-posterior pelvic diameter (APD), differential renal function (DRF) and length of hospital stay and total hospitalization costs.
CONCLUSION: Our study suggests that while all three robotic approaches achieve similar surgical outcomes for pediatric UPJO. Notably, the single-port technique offers additional advantages in minimizing surgical incisions. However, its potential cosmetic advantages remain to be confirmed through studies incorporating validated cosmetic outcome measures. These findings should be considered preliminary and require validation in larger prospective or multicenter studies.