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Laparoscopic Versus Robot-Assisted Pyeloplasty in Adults-A Single-Center Experience.

Orel CarmonaZohar A DotanMiki HaiflerBarak RosenzweigDorit Esther Zilberman
Published in: Journal of personalized medicine (2022)
Background : Laparoscopic (LP) and robot-assisted pyeloplasty (RAP) are minimally invasive techniques for correcting uretero-pelvic junction obstruction (UPJO). We retrospectively compared the clinical outcomes of all adults who underwent RAP ( n = 41) to those who underwent LP ( n = 24) for UPJO at our institution between 2003-2022. Methods : Age, sex, body mass index, surgical side, past abdominal/endoscopic surgeries, pre- and postoperative renal scans, pre- and postoperative serum creatinine levels, operative time (OT), presence of crossing vessels, estimated blood loss, postoperative complications, length of hospital stay, time to JJ stent removal, follow-up length, and postoperative hydronephrosis were analyzed. Results : The groups were demographically comparable. The mean total and skin-to-skin OTs (minutes) were significantly longer in the RAP group than in the LP group (242.4 ± 55 vs. 161.4 ± 40 p < 0.001; 163.7 ± 41.8 vs. 124.3 ± 30.3 p = 0.006, respectively). Hospital stay (days) was shorter in the RAP group (3.3 ± 2.1 vs. 7.3 ± 2.5 p < 0.001). Postoperative complication rates were identical for both groups. The LP group had a significantly longer follow-up period (85.2 ± 73 vs. 19 ± 14 months p < 0.001). The success rates for the LP and RAP groups were 87.5% and 90.6% ( p = 0.708). Conclusions : RAP achieves equivalent results to LP, in adult patients. A longer OT may be expected with the robotic system since it can handle more complicated cases.
Keyphrases
  • robot assisted
  • minimally invasive
  • patients undergoing
  • body mass index
  • healthcare
  • computed tomography
  • acute care
  • magnetic resonance