Robotic-assisted laparoscopic pyeloplasty as management for recurrent ureteropelvic junction obstruction: a comparison study with primary pyeloplasty

被引:10
作者
Zhang, Peng [1 ]
Shi, Taoping [1 ]
Fam, Xenginn [2 ]
Gu, Liangyou [1 ]
Xuan, Yundong [1 ]
Yang, Luojia [1 ]
Wang, Baojun [1 ]
Ai, Xing [3 ]
Jia, Zhuomin [3 ]
Li, Hongzhao [1 ]
Zhang, Xu [1 ]
Ma, Xin [1 ]
机构
[1] Chinese Peoples Liberat Army Gen Hosp, Dept Urol, State Key Lab Kidney Dis, Med Sch Chinese PLA, 28 Fuxing Rd, Beijing 100853, Peoples R China
[2] UKM Med Ctr, Dept Surg, Urol Unit, Kuala Lumpur, Malaysia
[3] PLA Army Gen Hosp, Dept Urol, Beijing 100853, Peoples R China
关键词
Robotic-assisted laparoscopic pyeloplasty (RALP); treatment failure; secondary ureteropelvic junction obstruction (secondary UPJO); FAILED PYELOPLASTY; CHILDREN; REPAIR; ENDOPYELOTOMY; OUTCOMES;
D O I
10.21037/tau.2020.03.25
中图分类号
R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
摘要
Background: To analyze the perioperative parameters and outcomes of robotic-assisted laparoscopic pyeloplasty (RALP) for recurrent ureteropelvic junction obstruction (UPJO) and compare them with our series of RALP for primary UPJO. Secondary pyeloplasty can be a challenging procedure because of ureteral devascularization, fibrosis and dense stricture formation. Robotic approach could be adjunct to these repairs. Methods: Between August 2015 to March 2019, 96 patients in our hospital underwent RALP, with 32 patients as secondary intervention for recurrent UPJO. We compared the perioperative parameters of RALP for both primary UPJO and recurrent UPJO. Patient demographics, perioperative parameters, postoperative outcomes and complications from both groups were analyzed and compared. Results: RALP was successfully performed for all cases in both groups. The median operating time was longer for secondary RALP than for primary RALP [125 (108.5-155) vs. 151 (120-190) minutes, P=0.004]. There were no conversions to open surgery or significant perioperative complications. No difference in blood loss, transfusion rate and perioperative complication rates was noted between the two groups. The success rates were 98.44% (63/64) and 96.88% (31/32) at a median follow up of 32 and 20 months (P=0.001) for the primary and secondary groups, respectively. Conclusions: Secondary RALP is associated with significantly longer operative time as compared to primary RALP, especially during the exposure of the UPJO, however it is a safe surgical modality for recurrent UPJO with durable outcome. RALP should be an alternative treatment modality for recurrent UPJO whenever the facility and expert are available.
引用
收藏
页码:1278 / 1285
页数:8
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