Comparison of Pediatric Robotic-assisted Laparoscopic Nephroureterectomy and Laparoendoscopic Single-site Nephroureterectomy

Bansal, Danesh; Cost, Nicholas G.; Bean, Cynthia; Riachy, Edward; DeFoor, William; Reddy, Pramod; Minevich, Eugene; Noh, Paul H.

doi:10.1016/j.urology.2013.08.066

Cited by 30 publications

(14 citation statements)

References 20 publications

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“…At the same time, the size of the wound could directly affect the patient's postoperative pain. Bansal et al also agreed with the potential cosmetic benefits of this minimally invasive surgery [21]. According to our analysis, the length and number of skin incisions had a positive correlation with the VPS and oral analgesic dose.…”

Section: Discussionsupporting

confidence: 84%

Comparison of modified transumbilical laparoendoscopic single-site nephroureterectomy and retroperitoneal laparoscopic nephroureterectomy: initial experience.

Shen

Zhu

et al. 2019

Videosurgery and Other Miniinvasive Techniques

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A b s t r a c tIntroduction: Owing to the development of the laparoendoscopic single-site (LESS) procedure, transumbilical LESS nephroureterectomy (LESS-NU) has become a new approach for treating upper tract urothelial carcinoma. Aim: The aim of this study is to introduce a modified LESS-NU procedure with bladder cuff excision for treating upper tract urothelial carcinoma (UTUC). We compared its clinical efficacy and postoperative outcomes in terms of follow-up time with traditional retroperitoneal laparoscopic nephroureterectomy (RL-NU). Material and methods: From May 2014 to May 2019, we performed nephroureterectomy on 42 patients using the retroperitoneal approach and a modified LESS approach. A retrospective analysis was conducted for the evaluation of the clinical and postoperative outcomes between the two groups. Results: The study included 25 LESS-NU and 17 RL-NU patients. All the procedures were completed successfully. The LESS-NU group had a significantly shorter mean operative time than the 236.18 min, p = 0.005). The differences in skin incision length (2.88 cm, 8.94 cm, p < 0.001) and oral analgesic dose (n = 1.12, n = 2.75, p < 0.001) between LESS-NU and RL-NU were statistically significant. Conclusions: Modified LESS-NU is a feasible and safe procedure. Compared with the retroperitoneal laparoscopic approach, the single-site approach did not alter the patients' position. LESS-NU is a better procedure for treating UTUC than RL-NU in terms of cosmetic result and postoperative pain.

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Section: Discussionsupporting

confidence: 84%

Comparison of modified transumbilical laparoendoscopic single-site nephroureterectomy and retroperitoneal laparoscopic nephroureterectomy: initial experience.

Shen

Zhu

et al. 2019

Videosurgery and Other Miniinvasive Techniques

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“…Of note, one study was excluded as it compared LNU and RANU in a paediatric population [16] , and two studies were excluded as case series included LNU and RANU but the individual data for each were not extractable [17] , [18] . The remaining seven studies excluded did not compare or report on LNU and RANU, but reported case series of one procedure or the other, or review papers.…”

Section: Resultsmentioning

confidence: 99%

Laparoscopic vs robotic nephroureterectomy: Is it time to re-establish the standard? Evidence from a systematic review

Stonier

Simson

Lee

et al. 2017

Arab Journal of Urology

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ObjectiveTo conduct a systematic review of comparative studies of laparoscopic nephroureterectomy (LNU), the standard management for upper urothelial tumours, and robot-assisted NU (RANU) that has emerged as a viable alternative.MethodsMEDLINE, EMBASE and the Cochrane Library were searched according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to identify all studies reporting on both LNU and RANU for upper urothelial tract tumours.ResultsIn all, 1630 patients were included, of which 838 underwent LNU and 792 RANU. Three studies reported on mean operative time and found it to be less in LNU, with two reporting this to be significant (RANU 298 vs LNU 251 min, P = 0.03; 306 vs 234 min, respectively, P < 0.001). Both studies reporting on median node count found this to be higher in the robotic groups: RANU 5.5 vs LNU 1.0 and RANU 21 vs LNU 11. Positive surgical margins (RANU 1.69% vs LNU 7.06%, P = 0.18), bladder recurrence (24.6% vs 36.89%, P = 0.09), and distant metastases (27.50% vs 17.50%, P = 0.29) were not significantly different between the two techniques. Disease-specific mortality did not differ between the two techniques (RANU 7.5% vs LNU 12.5%, P = 0.46), but postoperative mortality was reduced in RANU (0.14% vs 1.32%, P = 0.03). Overall complication rates were statistically lower in RANU, at 12.5% vs 18.8% (P < 0.001).ConclusionsThis review suggests these techniques are equivalent in terms of perioperative and oncological performance. Furthermore, there may be a lower overall complication rate, as well as postoperative mortality in the robotic group. Further research in the form of a randomised controlled trial is warranted.

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“…16 Miscellaneous Paediatric urology procedures without a reconstructive element have adapted well to traditional laparoscopic approach; nevertheless, there is extensive literature documenting the use of robotics in hemi-nephrectomy 17 and nephroureterectomy. 18 Those surgeries that must access the pelvis and therefore have a narrow field may well suit a robotic approach. Indeed, there are reports of robotic-assisted excision of bladder diverticulum, 19 urachal cyst excision, 20 excision of posterior urethral diverticulae, 21 prostatic utricles, 22 seminal vesicle cyst, 23 and varicocele.…”

Section: Robotic-assisted Pyeloplasty (Rap)mentioning

confidence: 99%

Paediatric robotic surgery

Cave

Clarke

2018

annals

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Comparison of Pediatric Robotic-assisted Laparoscopic Nephroureterectomy and Laparoendoscopic Single-site Nephroureterectomy

Cited by 30 publications

References 20 publications

Comparison of modified transumbilical laparoendoscopic single-site nephroureterectomy and retroperitoneal laparoscopic nephroureterectomy: initial experience.

Comparison of modified transumbilical laparoendoscopic single-site nephroureterectomy and retroperitoneal laparoscopic nephroureterectomy: initial experience.

Laparoscopic vs robotic nephroureterectomy: Is it time to re-establish the standard? Evidence from a systematic review

Paediatric robotic surgery

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