Robotic-assisted laparoscopic ureterocalicostomy (RALUC): a systematic review of its applications.

PURPOSE: Ureterocalicostomy refers to the anastomosis between the lower pole calyces and the ureter. Robotic-assisted laparoscopic ureterocalicostomy (RALUC) is gaining ground, ultimately. The current systematic review summarizes all applications of RALUC in both adults and children.

METHODS

In line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Guidelines, three databases (PubMed, Scopus and Cochrane) were screened, from their inception to 16 February 2025. The following search string was used: robotic AND (ureterocalicostomy OR ureterocalicostomies OR ureterocalycostomy OR ureterocalycostomies).

RESULTS

Eight studies fulfilled all inclusion criteria and were finally considered for qualitative synthesis. The rate of patients who had undergone previous pyeloplasty ranged in included studies from 20% to 100%, while the rate of patients who had undergone a nephrostomy tube placement before the ureterocalicostomy ranged from 38% to 100%. Total operative time ranged from 157.6 (90-240) to 272 min, while estimated blood loss ranged from 27.5 (10-75) to 115 (50-200) mL. Reoperation rates ranged from 0% to 50%, while the success rates ranged from 66.7% to 100%. Finally, taking into consideration the Clavien-Dindo Classification System, the Grade I-II complications ranged from 0% to 40%, while the Grade III-IV ones ranged from 0% to 20%.

CONCLUSION

RALUC is a feasible, safe and efficient procedure for patients with complicated ureteropelvic junction obstruction. The implementation of higher-quality studies on larger samples, including comparative ones and randomized controlled trials, is crucial in order to draw safer conclusions.