Gao Jian, Zhang Shufeng, Wang Lin, Wang Xiaohui
Department of Pediatric Surgery, Henan Provincial People's Hospital, 7# Weiwu Road, Zhengzhou, 450003, Henan, P.R. China.
Zhengzhou University People's Hospital, Henan University People's Hospital, Zhengzhou, China.
Sci Rep. 2025 Apr 21;15(1):13737. doi: 10.1038/s41598-025-99115-4.
To evaluate the safety and efficacy of robotic-assisted laparoscopic pyeloplasty (RALP) in infants under 6 months of age with ureteropelvic junction obstruction (UPJO). A retrospective analysis was conducted on infants aged ≤ 6 months who underwent RALP for UPJO between March 2021 and June 2024. Surgical indications included ultrasonographic evidence of severe hydronephrosis, progressive postnatal hydronephrosis, or symptoms related to hydronephrosis compression. Data on demographic characteristics, surgical details, postoperative complications, and follow-up outcomes were analyzed. Among 52 infants (34 male, 18 female), the median age was 70 days (IQR: 45, 107; 95% CI: 61, 87) and mean weight was 5.90 ± 1.39 kg (95% CI: 5.5, 6.3). All procedures were completed robotically without conversion. The mean operative time was 189 ± 34 min (95% CI: 177, 197) with median blood loss of 8.5 mL (IQR: 6.4, 11.3; 95% CI: 7.7, 9.7). Double-J stent placement (4.7 F) was successful in all cases. The median hospital stay was 4.0 days (IQR: 3.0, 4.0; 95% CI: 3.0, 4.0). Postoperative complications occurred in 7 patients (13.5%), including Clavien-Madadi grade I (n = 2), II (n = 4), and III (n = 1). At 3-month follow-up, the mean anteroposterior diameter (APD) decreased from 30.6 ± 8.6 mm to 11.8 ± 6.8 mm (P < 0.0001), and the mean parenchymal thickness increased from 2.4 ± 1.2 mm to 6.6 ± 2.1 mm (P < 0.0001). Success rate was 100% at median follow-up of 21 months (IQR: 16, 26; 95% CI: 19,23). RALP represents a safe and effective treatment option for UPJO in infants age ≤ 6 months, demonstrating excellent short-term outcomes and acceptable complication rates.
评估机器人辅助腹腔镜肾盂成形术（RALP）治疗6个月以下输尿管肾盂连接部梗阻（UPJO）婴儿的安全性和有效性。对2021年3月至2024年6月期间因UPJO接受RALP手术的年龄≤6个月的婴儿进行回顾性分析。手术指征包括严重肾积水的超声证据、出生后进行性肾积水或与肾积水压迫相关的症状。分析了人口统计学特征、手术细节、术后并发症和随访结果的数据。52例婴儿（男34例，女18例）中，中位年龄为70天（四分位间距：45，107；95%可信区间：61，87），平均体重为5.90±1.39kg（95%可信区间：5.5，6.3）。所有手术均通过机器人完成，无需中转。平均手术时间为189±34分钟（95%可信区间：177，197），中位失血量为8.5mL（四分位间距：6.4，11.3；95%可信区间：7.7，9.7）。所有病例双J管（4.7F）置入均成功。中位住院时间为4.0天（四分位间距：3.0，4.0；95%可信区间：3.0，4.0）。7例患者（13.5%）发生术后并发症，包括Clavien-Madadi I级（n=2）、II级（n=4）和III级（n=1）。在3个月随访时，平均前后径（APD）从30.6±8.6mm降至11.8±6.8mm（P<0.0001），平均实质厚度从2.4±1.2mm增加到6.6±2.1mm（P<0.0001）。在中位随访21个月（四分位间距：16，26；95%可信区间：19，23）时成功率为100%。RALP是≤6个月婴儿UPJO的一种安全有效的治疗选择，具有良好的短期效果和可接受的并发症发生率。
