Mizuno Kentaro, Nishio Hidenori, Matsumoto Daisuke, Sakata Takuya, Nakane Akihiro, Kamisawa Hideyuki, Kurokawa Satoshi, Maruyama Tetsuji, Tozawa Keiichi, Yasui Takahiro, Hayashi Yutaro
Department of Pediatric Urology Nagoya City University Graduate School of Medical Sciences Nagoya Japan.
Department of Urology Nagoya City University West Medical Center Nagoya Japan.
BJUI Compass. 2025 Jul 22;6(7):e70054. doi: 10.1002/bco2.70054. eCollection 2025 Jul.
This study aims to assess the surgical outcomes of laparoscopic or robotic surgery for primary vesicoureteral reflux and elucidate the factors contributing to vesicoureteral reflux resolution.
We retrospectively reviewed the medical records of consecutive patients who underwent extravesical laparoscopic ureteral reimplantation or robot-assisted laparoscopic ureteral reimplantation at our institution between March 2012 and July 2020. First, we reviewed surgical outcomes in the paediatric ( = 100) and adult ( = 15) patient groups. Second, we compared the surgical findings and outcomes of both procedures in the paediatric patient group and investigated the factors contributing to surgical success in the paediatric patient group.
The combined success rates for both procedures were 89.1% in the paediatric group and 70.0% in the adult group. The overall success rate among paediatric patients was not significantly different between those who underwent laparoscopic ureteral reimplantation (91.1%) and those who underwent robot-assisted laparoscopic ureteral reimplantation (85.5%). Post-operative urinary retention was observed in 5.0% and 6.7% of paediatric and adult patients, respectively. Univariate and multivariate analyses revealed that the ureteral diameter measured during surgery was significantly associated with vesicoureteral reflux resolution regardless of the use of a robotic platform ( = 0.046).
Both laparoscopic and robot-assisted laparoscopic ureteral reimplantation are favourable and safe procedures for paediatric patients with primary vesicoureteral reflux. To improve the success rate, a sufficient length of the submucosal tunnel must be ensured based on intraoperative measurements of ureteral diameter.
本研究旨在评估腹腔镜或机器人手术治疗原发性膀胱输尿管反流的手术效果，并阐明导致膀胱输尿管反流缓解的因素。
我们回顾性分析了2012年3月至2020年7月期间在我院接受膀胱外腹腔镜输尿管再植术或机器人辅助腹腔镜输尿管再植术的连续患者的病历。首先，我们回顾了儿科（n = 100）和成人（n = 15）患者组的手术结果。其次，我们比较了儿科患者组两种手术的手术发现和结果，并调查了儿科患者组手术成功的因素。
儿科组两种手术的联合成功率为89.1%，成人组为70.0%。接受腹腔镜输尿管再植术的儿科患者（91.1%）和接受机器人辅助腹腔镜输尿管再植术的儿科患者（85.5%）的总体成功率无显著差异。儿科和成人患者术后尿潴留的发生率分别为5.0%和6.7%。单因素和多因素分析显示，无论是否使用机器人平台，手术中测量的输尿管直径与膀胱输尿管反流的缓解显著相关（P = 0.046）。
腹腔镜和机器人辅助腹腔镜输尿管再植术对于原发性膀胱输尿管反流的儿科患者都是有利且安全的手术。为提高成功率，必须根据术中输尿管直径的测量确保黏膜下隧道有足够的长度。
