Department of Urology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India.
World J Urol. 2010 Oct;28(5):599-602. doi: 10.1007/s00345-009-0469-y. Epub 2009 Aug 27.
To assess the feasibility and outcomes of robotic pyeloplasty for complicated cases of ureteropelvic junction obstruction (UPJO).
Complicated UPJO cases included patients with the following: concomitant multiple or calyceal stones, secondary UPJO (post-ureteroscopy, open or percutaneous surgery), malrotated kidney, horseshoe kidney, ectopic kidney, giant hydronephrosis, poorly functioning kidney (glomerular filtration rate <20 ml/min), non-redundant renal calyces (requiring nephroplication), ptosis of the kidney (requiring nephropexy), long stricture (>2 cm), age <5 or >60 years and duplex pelvis. All cases underwent dismembered robotic pyeloplasty. Data were collected for operative time, blood loss, stone clearance, analgesic usage and time to recovery. Follow-up was done with intravenous urography and dynamic renal scan.
A total of 29 cases underwent dismembered robotic pyeloplasty with an average operative time and blood loss of 130 min and 50 ml. Stone clearance could be achieved in 8 out of 10. The average follow-up period was 15 months with a symptomatic and objective success rate of 96.6% (28/29). No perioperative complications were noted.
Robotic pyeloplasty for complicated cases of UPJO is feasible, safe and effective, and has a durable success rate.
评估机器人肾盂成形术治疗复杂输尿管肾盂连接部梗阻（UPJO）病例的可行性和结果。
复杂 UPJO 病例包括以下患者：合并多发或肾盂结石、继发性 UPJO（输尿管镜术后、开放或经皮手术）、肾旋转不良、马蹄肾、异位肾、巨大肾盂积水、肾功能不良（肾小球滤过率<20ml/min）、非冗余肾盂（需要肾盂成形术）、肾下垂（需要肾固定术）、长段狭窄（>2cm）、年龄<5 岁或>60 岁和双肾盂。所有病例均行离断式机器人肾盂成形术。收集手术时间、出血量、结石清除率、镇痛药使用情况和恢复时间的数据。随访采用静脉尿路造影和动态肾扫描。
共 29 例患者接受离断式机器人肾盂成形术，平均手术时间和出血量分别为 130 分钟和 50 毫升。10 例中有 8 例可达到结石清除。平均随访时间为 15 个月，症状性和客观成功率为 96.6%（28/29）。无围手术期并发症。
机器人肾盂成形术治疗复杂 UPJO 是可行、安全和有效的，具有持久的成功率。
