Comparative Outcomes of Robot-Assisted vs Traditional Laparoscopic Ureteral Reimplantation for Lower Ureteral Stenosis: A Single Center Study

机器人辅助腹腔镜与传统腹腔镜输尿管再植术治疗下段输尿管狭窄的疗效比较:单中心研究

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Abstract

BACKGROUND Robot-assisted laparoscopic ureteral bladder reimplantation (RALUR) has shown fewer operative and postoperative complications than traditional laparoscopic ureteral reimplantation (LUR) in treating ureteral stenosis. This study from a single center aimed to compare clinical outcomes from RALUR and LUR in treating 34 lower ureteral stenosis patients. MATERIAL AND METHODS Clinical data [visual analogue scale (VAS), complications, glomerular filtration rate (GFR), degree of pelvis separation, and degree of ureteral dilation] from lower ureteral stenosis patients treated with RALUR (n=14) and LUR (n=20) from January 2019 to January 2023 were analyzed. RESULTS Operation time (P=0.025) and postoperative hemoglobin decline (P=0.003) in the RALUR group were significantly lower than in the LUR group. Postoperative drainage tube removal time (P<0.001) and postoperative hospital stay (P=0.017) in the RALUR group were significantly shorter than in the LUR group. The total hospitalization cost of RALUR was significantly higher than that of LUR (P<0.001). There were no differences in postoperative VAS and complications between the 2 groups (P=0.58/P=1.000). Renal pelvis separation length (P<0.001) and degree of ureteral dilation (P<0.001) of the affected side were reduced in the RALUR group at 6 months postoperation, and GFR was significantly improved (P<0.001). In the LUR group, separation of the affected renal pelvis (P<0.001) and degree of ureteral dilation (P<0.001) were significantly reduced 6 months postoperation. The degree of renal pelvis separation in the RALUR group was significantly greater than in the LUR group (P=0.030), but the difference in degree of ureteral dilation (P=0.084) and affected kidney GFR (P=0.928) between the 2 groups was not significant. CONCLUSIONS Compared with LUR, RALUR has advantages of less bleeding, shorter operation time, higher safety, shorter postoperative hospital stay, faster recovery, less perioperative complications, and a more precise curative effect.

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