COMPARISON BETWEEN ROBOTIC ASSISTED LAPAROSCOPIC PYELOPLASTY AND LAPAROSCOPIC PYELOPLASTY AS STANDARD OF CARE FOR PELVI-URETERIC JUNCTION OBSTRUCTION: HOSPITAL-BASED COHORT STUDY.

Kumar  Pankaj; Neha  Verma; Manjunath K; Suvit Suresh  Jumde; Rishin  Dutta; Prashanth M. Kulkarni

doi:10.51168/sjhrafrica.v5i9.1293

Authors

Kumar Pankaj Assistant Professor, Department of Urology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, India
Neha Verma Assistant Professor, Department of Community Medicine, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, India
Manjunath K Junior Consultant, Department of Urology, Narayana Hrudayalaya, Bangalore, India
Suvit Suresh Jumde Assistant Professor, Department of Urology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, India
Rishin Dutta Senior Resident, Department of Urology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, India
Prashanth M. Kulkarni Senior Consultant, Department of Urology, Narayana Hrudayalaya, Bangalore, India

DOI:

https://doi.org/10.51168/sjhrafrica.v5i9.1293

Keywords:

Pyeloplasty, Laparoscopic pyeloplasty, Robotic-assisted pyeloplasty, Pelvi-Ureteric Junction Obstruction

Abstract

Introduction

Pelvi-Ureteric Junction Obstruction (PUJO) is a significant clinical difficulty that frequently necessitates surgical treatment. This study examines and contrasts the efficacy of Robotic-Assisted Laparoscopic Pyeloplasty (RALP) and Laparoscopic Pyeloplasty (LP) in treating this problem. The objective is to assess perioperative parameters and patient outcomes to identify the most effective technique for controlling PUJO.

Methods

The study comprised individuals diagnosed with PUJO who were scheduled to undergo surgical intervention. The study included a total of 48 patients, with 32 of them undergoing LP and the remaining 16 getting RALP.

Results

48 patients (32 LP, 16 RALP) aged 10-70 years were studied, with mean ages of 34.28 (LP) and 39.38 (RALP), a male-to-female ratio of 2.2:1, and success rates of 90.63% (LP) and 93.75% (RALP) in transitioning from an obstructed (TYPE 2) to a normal (TYPE 1) O' The RALP group had a longer mean operative time (226.87 ± 32.39 minutes) than the LP group (186.53 ± 33.58 minutes). The RALP group had better patient outcomes, including faster drain removal time (1.69 ± 1.40 days vs. 3.75 ± 1.50 days), shorter hospital stay (2.88 ± 0.88 days vs. 4.06 ± 1.39 days), and somewhat higher success rate (93.75% vs. 90.63%). The success criteria were an obstructed (TYPE 2) to normal (TYPE 1) O'Reilly Curve within 3 months of surgery.

Conclusion

Although RALP has a longer operational time, it has been shown to achieve better results than LP in terms of success rate, duration of drain usage, and total length of hospital stay.

Recommendations

It is recommended that future studies include larger sample sizes and longer follow-up periods to further evaluate the long-term effectiveness of RALP and LP in the management of PUJO.