Yang Jian-Wei, Wang Li, Wu Zhongrui, Wang Kang-Yu, Li Kun-Peng, Wan Shun, Zhao Liang, Chen Si-Yu, Yang Li
Department of Urology, The Second Hospital of Lanzhou University, Lanzhou, China.
Gansu Province Clinical Research Center for Urology, Lanzhou, 730030, People's Republic of China.
J Robot Surg. 2025 Feb 28;19(1):87. doi: 10.1007/s11701-025-02251-2.
This study evaluates and compares the results of single-port (SP-RAP) versus multi-port robot-assisted laparoscopic pyeloplasty (MP-RAP) for the treatment of ureteropelvic junction obstruction (UPJO). A systematic review and meta-analysis were conducted following PRISMA guidelines. Studies comparing SP-RAP and MP-RAP for UPJO treatment were identified from PubMed, Web of Science, and Cochrane Library databases. Key outcomes included operative time, hospital stay, and complication rates. Weighted mean differences (WMD) and risk ratios (RR) were calculated using fixed- or random-effects models based on heterogeneity. Statistical significance was set at P < 0.05. Both SP-RAP and MP-RAP demonstrated comparable surgical success rates (SP-RAP: 98.85%, MP-RAP: 98.08%), complication rates, and estimated blood loss. In the adult subgroup, SP-RAP was associated with shorter hospital stays (WMD: -0.52 days; P = 0.04). Postoperative morphine consumption was also lower in the SP-RAP group (WMD: -31.02 mg; P = 0.03), reflecting its minimally invasive nature. However, no significant differences were observed in operative time, pain scores, or renal function recovery between the two groups. Additionally, some studies suggested that SP-RAP may offer better cosmetic outcomes due to its single incision; however, due to the lack of standardized cosmetic satisfaction evaluation criteria, this finding is presented as a potential advantage rather than a definitive conclusion. The SP system demonstrates comparable safety and effectiveness to MP-RAP while offering advantages in cosmetic outcomes and recovery. Further long-term studies are needed to validate its benefits and optimize its application.
本研究评估并比较了单孔（SP-RAP）与多孔机器人辅助腹腔镜肾盂成形术（MP-RAP）治疗肾盂输尿管连接部梗阻（UPJO）的效果。按照PRISMA指南进行了系统评价和荟萃分析。从PubMed、科学网和Cochrane图书馆数据库中检索比较SP-RAP和MP-RAP治疗UPJO的研究。主要结局包括手术时间、住院时间和并发症发生率。根据异质性采用固定效应或随机效应模型计算加权平均差（WMD）和风险比（RR）。设定统计学显著性为P＜0.05。SP-RAP和MP-RAP均显示出相当的手术成功率（SP-RAP：98.85%，MP-RAP：98.08%）、并发症发生率和估计失血量。在成人亚组中，SP-RAP与较短的住院时间相关（WMD：-0.52天；P = 0.04）。SP-RAP组术后吗啡消耗量也较低（WMD：-31.02 mg；P = 0.03），反映了其微创性质。然而，两组在手术时间、疼痛评分或肾功能恢复方面未观察到显著差异。此外，一些研究表明，由于SP-RAP采用单一切口，可能具有更好的美容效果；然而，由于缺乏标准化的美容满意度评估标准，这一发现仅作为潜在优势而非定论呈现。SP系统与MP-RAP相比，在安全性和有效性方面相当，同时在美容效果和恢复方面具有优势。需要进一步的长期研究来验证其益处并优化其应用。
