Surgical outcomes of robot-assisted laparoscopic dismembered pyeloplasty

Tóm tắt

   Background: Robot-assisted laparoscopic surgery has been applied to adults since November 2016 at Binh Dan Hospital. Robot-assisted laparoscopic pyeloplasty has been performed for a long time. Currently, besides Binh Dan Hospital, several other units have implemented this technique, but there have been no domestic studies reported. Thus, the question arises about the efficacy and safety of robot-assisted laparoscopic dismembered pyeloplasty.

   Objectives: To evaluate the surgical outcomes of robot-assisted laparoscopic dismembered pyeloplasty.

   Methods: Data were collected from 55 cases of robot-assisted laparoscopic dismembered pyeloplasty performed at Binh Dan Hospital from January 2017 to June 2024. Patients were followed up for at least 6 months postoperatively to assess effectiveness alongside the safety of the procedure. Key outcomes included perioperative complications and improvements in clinical symptoms as well as radiological and renal function- related outcomes.

   Results: Among the 55 cases studied, 24 patients (43.6%) had a history of prior ipsilateral ureteral surgery. The mean operative time was 154.69 ± 61.17 minutes, and the mean blood loss was 68 ± 43.14 ml. Clavien-Dindo classification of surgical complications recorded: 47 cases (85.5%) without complications, 6 cases (10.9%) with grade I complications, 1 case (1.8%) with grade II complications, and 1 case (1.8%) with grade III complications. Follow-up with a mean duration of 32.12 ± 9.85 months showed a success rate of 90% (36/40 cases), with one case requiring open revision surgery due to urinary leakage, two cases requiring periodic JJ stenting for recurrent ureteral stricture, and one case requiring nephrectomy due to loss of kidney function.

   Conclusion: Robot-assisted laparoscopic dismembered pyeloplasty is a promising, safe, and effective method that can serve as an alternative to open surgery in complex or recurrent ureteropelvic junction obstruction cases. Larger studies with long-term follow-up are needed to evaluate the durability of this approach.

DOI: 10.59715/pntjmp.4.3.12