Journal of pediatric surgery · 2025
Long-Term Outcomes of Robotic-Assisted Laparoscopic Pyeloplasty for Unilateral Ureteropelvic Junction Obstruction in Infants.
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Zhang Xiaowei, Zhao Yang, Tao Tian, Cao Hualin, Yi Xiaoyu, Zhou Xiaoguang, Ma Lifei, Tao Yuandong, Jia Hongshuai, Wu Yangyang, Yue Guang, Li Pin, Zhou Huixia
Аннотация
PURPOSE: This study aims to assess the long-term outcomes of robotic-assisted laparoscopic pyeloplasty (RALP) for the treatment of ureteropelvic junction obstruction (UPJO) in infants under 3 months of age, and to compare these outcomes with those of infants aged 3-12 months.
MATERIALS AND METHODS: A retrospective cohort analysis was performed on 226 infants who underwent RALP between March 2017 and December 2021. Patients were stratified into two groups: Group A (aged <3 months, n = 114) and Group B (aged 3-12 months, n = 112). Preoperative evaluation included ultrasonography, magnetic resonance urography, and renal scintigraphy. Surgical outcomes, postoperative complications, and long-term follow-up data (median follow-up duration >70 months) were analyzed.
RESULTS: All procedures were completed successfully without conversion to open surgery. No significant differences were observed between the groups in terms of operative time (107.10 ± 23.26 vs. 102.57 ± 22.79 min, P = 0.152), estimated blood loss, or length of hospital stay. The incidence of febrile urinary tract infections was 9.65 % in Group A and 7.14 % in Group B (P = 0.633). Both groups demonstrated significant improvements in anteroposterior pelvic diameter (ΔAPD: -1.70 ± 0.98 vs. -1.60 ± 1.00 cm) and split renal function (ΔSRF: +6.99 ± 4.16 % vs. +6.35 ± 3.93 %).
CONCLUSION: RALP is a safe and effective treatment for unilateral UPJO in infants under 3 months of age, with outcomes comparable to those observed in older infants. Early surgical intervention does not increase surgical risks, though further research is needed to explore long-term renal function outcomes.
MATERIALS AND METHODS: A retrospective cohort analysis was performed on 226 infants who underwent RALP between March 2017 and December 2021. Patients were stratified into two groups: Group A (aged <3 months, n = 114) and Group B (aged 3-12 months, n = 112). Preoperative evaluation included ultrasonography, magnetic resonance urography, and renal scintigraphy. Surgical outcomes, postoperative complications, and long-term follow-up data (median follow-up duration >70 months) were analyzed.
RESULTS: All procedures were completed successfully without conversion to open surgery. No significant differences were observed between the groups in terms of operative time (107.10 ± 23.26 vs. 102.57 ± 22.79 min, P = 0.152), estimated blood loss, or length of hospital stay. The incidence of febrile urinary tract infections was 9.65 % in Group A and 7.14 % in Group B (P = 0.633). Both groups demonstrated significant improvements in anteroposterior pelvic diameter (ΔAPD: -1.70 ± 0.98 vs. -1.60 ± 1.00 cm) and split renal function (ΔSRF: +6.99 ± 4.16 % vs. +6.35 ± 3.93 %).
CONCLUSION: RALP is a safe and effective treatment for unilateral UPJO in infants under 3 months of age, with outcomes comparable to those observed in older infants. Early surgical intervention does not increase surgical risks, though further research is needed to explore long-term renal function outcomes.