Outcomes of robot-assisted laparoscopic pyeloplasty for ureteropelvic junction obstruction with small pelvis in children

Q4 Medicine

中华小儿外科杂志 Pub Date : 2020-03-15 DOI:10.3760/CMA.J.ISSN.0253-3006.2020.03.004

C. Tao, D. Tang, Zheming Xu, Long Sun, Z. Gao, Qingjiang Chen, Q. Shu

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引用次数: 0

Abstract

Objective To summarize the experience of robotic-assistant laparoscopic pyeloplasty (RALP) for ureteropelvic junction obstruction (UPJO) with small pelvis in children. Methods A retrospective analysis was performed on clinical data of 12 UPJO children (small pelvis) undergoing RALP from March 2018 to October 2019. Their clinical presentations, operative approaches and follow-up data were analyzed. There were 7 boys and 5 girls with a mean age of 7(4-15) years. The involved side was left (n=9) and right (n=3). Ultrasound at 1-7 days preoperatively indicated anterioposterior diameter (APD) 3.5 cm during an on set of abdominal pain. And radionuclide examination hinted at different declining levels of renal function and the function of affected kidney ranged from 6% to 43%. Results RALP was performed all successfully without a conversion into open surgery. The pathogenesis was simple stricture or torsion (n=3), polyps (n=3), ectopic vascular compression (n=4), calculus incarceration with infection (n=1) and postcaval ureter (n=1). The average operative duration was 165(115-225) min and the average ureteropelvic anastomosis time 50(40-60) min. There were no obvious intraoperative complications and the mean volume of blood loss was <10 ml. The average follow-up period was 12(2-22) months. The mean preoperative value of APD was (1.87±0.57)cm and the mean postoperative value of APD (1.16±0.82)cm (P<0.05). Conclusions Robot-assisted laparoscopic pyeloplasty may be employed for pediatric UPJO with small renal pelvis (APD<2.5 cm). Such a technique is easy to learn and clinical application prospects are excellent. Key words: Child; Robot assisted laparoscopic surgery; Hydronephrosis; Ureteropelvic junction obstruction

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机器人辅助腹腔镜肾盂成形术治疗儿童小骨盆输尿管盂连接处梗阻的疗效

目的总结机器人辅助腹腔镜肾盂成形术(RALP)治疗儿童小骨盆肾盂输尿管交界处梗阻(UPJO)的经验。方法回顾性分析2018年3月至2019年10月12例UPJO儿童(小骨盆)行RALP的临床资料。分析两例患者的临床表现、手术入路及随访资料。男童7例，女童5例，平均年龄7(4-15)岁。受累侧为左侧(n=9)和右侧(n=3)。术前1-7天超声提示:前后腹直径(APD) 3.5 cm。放射性核素检查提示不同程度的肾功能下降，影响肾功能的范围为6% ~ 43%。结果RALP手术均成功，未转开。发病机制为单纯狭窄或扭转(n=3)、息肉(n=3)、异位血管受压(n=4)、结石嵌顿合并感染(n=1)和腔静脉后输尿管(n=1)。平均手术时间165(115-225)min，平均输尿管-肾盂吻合时间50(40-60)min，术中无明显并发症，平均失血量<10 ml，平均随访12(2-22)个月。术前APD平均值为(1.87±0.57)cm，术后APD平均值为(1.16±0.82)cm (P<0.05)。结论机器人辅助腹腔镜肾盂成形术可用于小肾盂(APD<2.5 cm)的儿童UPJO。该技术易学，临床应用前景良好。关键词:儿童;机器人辅助腹腔镜手术;肾盂积水;输尿管盂连接处梗阻

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来源期刊

中华小儿外科杂志 Medicine-Pediatrics, Perinatology and Child Health

CiteScore

0.40

自引率

0.00%

发文量

8707

期刊介绍： Chinese Journal of Pediatric Surgery is an academic journal sponsored by the Chinese Medical Association. It mainly publishes original research papers, reviews and comments in this field. The journal was founded in 1980 and is included in well-known databases such as Peking University Journal (Chinese Journal of Humanities and Social Sciences) and CSCD Chinese Science Citation Database Source Journal (including extended version). It is one of the national key academic journals under the supervision of the China Association for Science and Technology. Chinese Journal of Pediatric Surgery enjoys a high reputation and influence in the academic community. The articles published in this journal have a high academic level and practical value, providing readers with a large number of practical cases and industry information, and have received widespread attention and citations from readers.