Comparative Analysis Of Robotic-assisted And Laparoscopic Pyeloplasty In The Treatment Of Ureteropelvic Junction Obstruction In Children

Objective:To compare and analyze the clinical efficacy of robot-assisted laparoscopy pyeloplasty and laparoscopic pyeloplasty in the treatment of ureteropelvic junction obstruction(UPJO)in children,and summarize the clinical experience and advantages of robot-assisted laparoscopic pyeloplasty.Methods:A retrospective analysis was performed on the clinical data of children treated with robot-assisted laparoscopic pyeloplasty(RALP group)and laparoscopic pyeloplasty(LP group)in pediatric surgery department of Qilu Hospital of Shandong University from July 2020～October 2022,and the general clinical data(age,weight,gender,preoperative APD value,etc.),intraoperative indicators(operation time,intraoperative ureteropelvic anastomosis time,intraoperative blood loss,etc.)and postoperative indicators(postoperative hospital stay,postoperative complications,postoperative APD value total cost of hospitalization)were compared between the two groups.Analyze the advantages and disadvantages of the two surgical methods.Results:A total of 70 children were collected in this study,including 22 in RALP group and 48 in LP group.The postoperative APD values of the two groups were significantly lower than those before operation(P<0.001),and there was no significant difference in APD difference between the two groups before and after operation(P=0.590).Compared with LP group,the time of ureteropelvic anastomosis in RALP group was shorter(27.95±9.52 min vs 41.17±8.34 min,P<0.001).The total hospitalization cost of RALP group was 5.05(4.78,5.26)thousand yuan higher than that of LP group 3.63(3.38,3.84)thousand yuan,(P<0.001).There was no significant difference in operation time,intraoperative blood loss,postoperative hospital stay and postoperative complication rate between the two groups.Conclusion:Robot-assisted laparoscopic pyeloplasty is a safe and effective treatment for UP JO in children.Compared with laparoscopic pyeloplasty,it has a clearer field of vision,more precise suturing,shorter ureterope anastomosis time,shorter learning curve,and more ergonomic intraoperative ureteropeloplasty.The main disadvantages are the higher cost of hospitalization and the slightly larger scar of the Trocar hole.