Efficacy Analysis of Laparoscopic Versus Robot-Assisted Laparoscopic Management for Postoperative Recurrent Obstruction Following Pyeloplasty
Liu Bowen
Wu Mingyang
Li Cong
Lu Zheng
Cao Hualin
Li Tianyu
Abstract：Objective:To investigate the clinical efficacy of laparoscopic and robot-assisted laparoscopic treat-ment for recurrent obstruction after pyeloplasty.Methods:A retrospective analysis was conducted on the clinical data of 21 patients with recurrent obstruction after pyeloplasty,who were treated at the Department of Urology,First Af-filiated Hospital of Guangxi Medical University,and Nanxishan Hospital(Second People's Hospital of Guangxi Zhuang Autonomous Region)from June 2021 to March 2023.The cohort included 9 females and 12 males,with 7 cases on the right side and 14 on the left side.The median age was 28.00(21.50,59.00)years.Perioperative data,postoperative complication rates,and follow-up results were collected and compared.Results:All 21 patients suc-cessfully underwent surgery without conversion to open surgery or severe intraoperative complications.Intraoperative findings included anastomotic stenosis in 15 cases,retained ectopic vessels in 2 cases,and high ureteral orifice in 4 cases.Dissection pyeloplasty was performed in 19 cases,and flap pyeloplasty in 2 cases.The mean operative time was(158.30±25.2)minutes,the median intraoperative blood loss was 25.00(20.00,35.00)ml,and the mean post-operative hospital stay was(8.67±1.56)days.The incidence of Clavien Ⅰ-Ⅱ grade complications was 19.00%(4/21),with no Clavien Ⅲ-Ⅳ grade complications.Postoperative ultrasound at 6 months showed a significant reduc-tion in anteroposterior diameter of the renal pelvis[(1.22±0.33)cm vs.(3.87±0.69)cm],with a statistically signifi-cant difference(t=15.98,P<0.01).Renal dynamic imaging at 1 year postoperatively indicated an increase in the function of the affected kidney[(42.05±5.87)%vs.(38.04±7.43)%],with a statistically significant difference(t=4.83,P<0.01).The median follow-up period was 32.00(26.00-39.50)months,with a success rate of 100%.Conclusion:Laparoscopic and robot-assisted laparoscopic treatment for recurrent obstruction after pyeloplasty is safe and feasible.The choice between dissection pyeloplasty and flap pyeloplasty should be based on the specific cause of obstruction and the length of ureteral stenosis.
Keywords：pyeloplastyureter stricturerobot-assistedlaparoscopic
Publication Date：2025-06-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 150-154 )