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Robot-assisted surgery versus laparoscopic surgery of ureteropelvic junction obstruction in children: a systematic review and meta-analysis

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Abstract

The clinical effectiveness and safety of robot-assisted laparoscopic pyeloplasty (RP) compared with laparoscopic pyeloplasty (LP) have not been clearly established in ureteropelvic junction obstruction (UPJO) children and require review. We searched in the Cochrane, MEDLINE, EMBASE, Web of Science, and CNKI database on 30 June 2022. This systematic review and meta-analysis were performed in RevMan 5.4 based on studies comparing RP versus LP in children with UPJO and subgroup analysis in children < 2 years of age has been performed. The Newcastle–Ottawa Scale was used to evaluate the studies. We included one RCT, and eighteen cohort studies, a total involving 3370 children. Compared with LP, RP showed higher surgical success rates (OR 2.57, 95%CI (1.24, 5.32), P < 0.05), lower postoperative complication rates (OR 0.61, 95%CI (0.38, 0.99), P < 0.05), shorter hospital stay (MD − 1.04, 95% CI (− 1.6, − 0.47), P < 0.05) as well as operative time (MD − 22.11, 95%CI (− 35.91, − 8.31), P < 0.05). No significant differences were detected for intraoperative complication rates or conversion to open surgery rates. RP is an alternative to UPJO with higher success rates, and less postoperative complications. Evidence on the effectiveness and safety of RP compared with LP for UPJO children is of low certainty. More quality evidence in the form of randomized controlled trials is needed to obtain more reliable analysis results.

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Availability of data and materials

The data used during the current study are available from the corresponding author on reasonable request.

Abbreviations

LP:

Laparoscopic pyeloplasty

RP:

Robotic pyeloplasty

RC:

Retrospective comparison

RCT:

Randomized controlled trial

NR:

Not report

UPJO:

Ureteropelvic junction obstruction

Cl:

Confidence interval

OR:

Odds ratio

SD:

Standard deviation

MD:

Median difference

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Acknowledgements

We thank Department of General Surgery, Anqing First People's Hospital Affiliated with Anhui Medical University for offering statistical support.

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Nil.

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Author notes

  1. Zhuming Chen and Huaiwen Xu are the first co-author and equally contributed to this study.

Authors and Affiliations

  1. Department of General Surgery, Anqing First People’s Hospital of Anhui Medical University, Anqing, China

    Zhuming Chen, Huaiwen Xu, Chaohui Wang, Shuangjiu Hu & Zhe Kai

  2. Department of General Surgery, Northern Jiangsu People’s Hospital, Clinical Medical College of Yangzhou University, Yangzhou, China

    Muhammad Ali & Yang Wang

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  1. Zhuming Chen
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Contributions

ZC and HW: design, statistical analysis and writing. CW, ZK and SH: data collection and data analysis. MA and WY: revision, and submission. ZK: supervision and final review. All authors contributed to the article and approved the submitted version.

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Correspondence to Zhe Kai.

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Prospero CRD42022343358.

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Chen, Z., Xu, H., Wang, C. et al. Robot-assisted surgery versus laparoscopic surgery of ureteropelvic junction obstruction in children: a systematic review and meta-analysis. J Robotic Surg 17, 1891–1906 (2023). https://doi.org/10.1007/s11701-023-01648-1

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