达芬奇机器人辅助手术治疗儿童双侧肾盂输尿管连接部狭窄

目的 初步总结达芬奇机器人辅助手术治疗儿童双侧肾盂输尿管交界部狭窄的经验,探讨达芬奇机器人手术同时治疗双侧肾盂输尿管交界部的安全性和有效性.方法 回顾性分析中山大学附属第一医院小儿外科2016年1月至2019年11月采用达芬奇机器人辅助手术治疗的7例双侧肾盂输尿管交界部狭窄患者临床资料.7例均为男性,年龄4岁6个月至1...

Robotic-assisted bilateral simultaneous dismembered pyeloplasties in children

Objective To summarize our institutional experiences of robotic-assisted laparoscopic(RAL)simultaneous treatment of bilateral ureteropelvic junction obstruction(UPJO)and evaluate its safety and feasibility.Methods A retrospective review was performed for 7 bilateral UPJO boys undergoing simultaneous bilateral robotic-assisted dismembering laparoscopic pyeloplasty between January 2016 and November 2019.The average age was 102(54-192)months.Three cases were prenatally diagnosed as bilateral hydronephrosis and hydronephrosis worsened during follow-ups.Another three children had a chief complain of flank pain and bilateral hydronephrosis was detected promptly.One case of severe bilateral hydronephrosis was diagnosed during a routine examination.Bilateral UPJO with SFU grade Ⅲ to Ⅳ hydronephrosis was confirmed preoperatively by ultrasound,nephrogram,computed tomography(CT)and magnetic resonance imaging(MRI).Results There was no need of open conversion.The mean operative duration was 177(147-204)min and the mean estimated volume of blood loss 8.8(2-20)ml.All children recovered well and were discharged with excellent cosmetic outcomes.The mean follow-up period was 15(3-49)months.After removal of ureteral stents,one of the children occured recurrence urinary infection,then bilateral Ⅲ grade of vesicoureteral reflux were found under a voiding cystourethrography,bilateral Cohen surgery were taken for this child soon after and he had no more urinary infection after that.All children's symptoms have disappeared,hydronephrosis of five renal units were resolved and nine renal units were improved.Conclusion With excellent cosmetic outcomes,robotic-assisted bilateral concurrent dismembering pyeloplasty is both safe and effective for bilateral UPJO.