Comparative Analysis of Robot Assisted Laparoscopy and Laparoscopic Pyeloplasty in the Treatment of Ureteropelvic Junction Obstruction

Abstract

Through the comparison with laparoscopic pyeloplasty, this paper discusses the clinical value of robot assisted laparoscopic pyeloplasty in the treatment of ureteropelvic junction obstruction (UPJO). 82 patients with UPJO admitted to the First Affiliated Hospital of Medical College of Zhejiang University from January 2012 to December 2018 were retrospectively analyzed, including 43 patients who underwent robot assisted laparoscopic pyeloplasty (RALP group); Laparoscopic pyeloplasty was performed in 39 cases (LP group). The operation time, reconstruction suture time, intraoperative bleeding, postoperative drainage, postoperative intestinal recovery time, postoperative hospitalization time, hospitalization expenses, surgical complications and follow-up were compared and analyzed between the two groups. There was no significant difference between the two groups in operation time, renal pelvis reconstruction time, intraoperative bleeding, postoperative drainage tube stopping time, postoperative drainage volume and intestinal recovery time (P > 0.05); and the postoperative indwelling time of urinary catheter and postoperative hospital stay in RALP group were shorter than those in LP group (P < 0.05); The hospitalization cost in RALP group was significantly higher than that in LP group. Clavien Grade II complications occurred in 8 cases in LP group, Clavien Grade II complications occurred in 2 cases in RALP group, and there was 1 case of Grade III complications in both groups. The complication rate was 6.79% in RALP group and 23.07% in LP group. There was significant difference between the two groups (P < 0.05). During the postoperative follow-up, hydronephrosis was aggravated in 1 patient in RALP group half a year after operation, and hydronephrosis was aggravated in 1 patient in LP group due to ureteral stone obstruction. Another patient in LP group was found to have more hydronephrosis than before. The success rate was 97.7% in RALP group and 94.8% in LP group. There was no significant difference between the two groups (P > 0.05). Compared with laparoscopy, robot assisted laparoscopic pyeloplasty is a better surgical option. With the reduction of cost, it will gradually replace laparoscopic pyeloplasty.