Abdulfattah Suhaib, Ai Emily, Quairoli Marina, Eftekharzadeh Sahar, Fischer Katherine, Aghababian Aznive, Weaver John, Godlewski Karl, Long Christopher, Weiss Dana, Mittal Sameer, Shukla Aseem, Srinivasan Arun
Division of Urology, Children's Hospital of Philadelphia, Philadelphia, PA.
Division of Urology, Children's Hospital of Philadelphia, Philadelphia, PA; Department of Urology, Jefferson Einstein Medical Center, Philadelphia, PA.
Urology. 2025 Jan;195:126-131. doi: 10.1016/j.urology.2024.10.030. Epub 2024 Oct 22.
To evaluate the outcomes of pre-toilet trained children undergoing robot-assisted laparoscopic ureteral reimplantation (RALUR) for the treatment of primary VUR at our institution and compare these to an older cohort.
This retrospective study analyzed data from a single institution's registry, comparing outcomes between pre-toilet trained and toilet trained children who underwent RALUR for primary VUR. Preoperative parameters, surgical details, and postoperative outcomes were evaluated.
The study included 158 patients, with 24 in the pre-toilet trained group and 134 in the toilet trained group. Both cohorts exhibited similar demographics and preoperative characteristics. Operative times, complication rates, and surgical outcomes were comparable between the groups, despite the pre-toilet trained group presenting with more severe VUR grades. Incidence of febrile urinary tract infection after surgery and need for further intervention did not significantly differ between the cohorts.
The current study demonstrates the feasibility, success, and safety of RALUR in pre-toilet trained compared to toilet trained children and thus supports the stance that it is a viable alternative to open surgery.
评估在我们机构中接受机器人辅助腹腔镜输尿管再植术（RALUR）治疗原发性膀胱输尿管反流（VUR）的如厕训练前儿童的治疗效果，并与年龄较大的队列进行比较。
这项回顾性研究分析了来自单一机构登记处的数据，比较了接受RALUR治疗原发性VUR的如厕训练前儿童和如厕训练儿童的治疗效果。评估了术前参数、手术细节和术后结果。
该研究纳入了158例患者，其中如厕训练前组24例，如厕训练组134例。两个队列的人口统计学特征和术前特征相似。尽管如厕训练前组的VUR分级更严重，但两组之间的手术时间、并发症发生率和手术结果相当。两组术后发热性尿路感染的发生率和进一步干预的需求没有显著差异。
当前研究表明，与如厕训练儿童相比，RALUR在如厕训练前儿童中具有可行性、成功率和安全性，因此支持其作为开放手术可行替代方案的立场。
