Children's Hospital of Philadelphia, University of Pennsylvania, 34th Street and Civic Center Boulevard, Wood Building 3rd Floor, Philadelphia, PA, 19104, USA.
J Robot Surg. 2010 Jan;3(4):215-7. doi: 10.1007/s11701-009-0164-4. Epub 2009 Nov 21.
Robot-assisted pyeloplasty (RAP) is emerging as an effective tool for treatment of ureteropelvic junction obstruction (UPJO) in the pediatric population. Typically stents are utilized for RAP and removed four weeks after the procedure. We present our prospective experience with stentless RAP. Twenty children between the ages of 12 and 113 months (mean age 56 months) underwent transperitoneal RAP for UPJO utilizing the DaVinci surgical system. Outcome measures included operative time, length of hospital stay, and resolution of obstruction by ultrasonography, magnetic resonance urography (MRU), and/or diuretic radionuclide imaging (DRI). All patients successfully underwent robot-assisted laparoscopic pyeloplasty without conversion to pure laparoscopy or open procedure. Mean operative time was 124.7 min with a mean console time of 82.3 min. The mean hospital stay was 18 h. Of the 20 patients, 13/20 (65%) had resolution or improvement in the degree of hydronephrosis. The other patients had no evidence of obstruction based upon follow-up MRU or DRI. Stentless RAP is a safe and effective option for surgical treatment of UPJO. A larger prospective long-term cohort is needed to confirm the safety and efficacy of the stentless approach.
机器人辅助肾盂成形术（RAP）作为治疗小儿肾盂输尿管连接部梗阻（UPJO）的有效工具正在兴起。通常在 RAP 中使用支架，并在手术后四周取出。我们介绍了无支架 RAP 的前瞻性经验。20 名年龄在 12 至 113 个月（平均年龄 56 个月）的儿童接受了经腹 RAP 治疗 UPJO，使用达芬奇手术系统。结果测量包括手术时间、住院时间以及超声、磁共振尿路造影（MRU）和/或利尿剂放射性核素成像（DRI）梗阻的缓解情况。所有患者均成功接受了机器人辅助腹腔镜肾盂成形术，无需转为纯腹腔镜或开放手术。平均手术时间为 124.7 分钟，控制台时间平均为 82.3 分钟。平均住院时间为 18 小时。20 名患者中，13/20（65%）例患者的肾盂积水程度得到缓解或改善。其他患者根据随访的 MRU 或 DRI 无梗阻证据。无支架 RAP 是治疗 UPJO 的一种安全有效的手术选择。需要更大的前瞻性长期队列来证实无支架方法的安全性和有效性。
