Yavuz Onur Danacioglu1, Ferhat Keser2, Salih Polat3, Bilal Gunaydin4, Yusuf Ilker Comez5, Mesrur Selcuk Silay6. 1. Department of Urology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey. 2. Department of Urology, Istanbul Medeniyet University School of Medicine, Istanbul, Turkey. 3. Department of Urology, Amasya University, Amasya, Turkey. 4. Department of Urology, Nigde Omer Halisdemir University, Nigde, Turkey. 5. Department of Urology, Uskudar University, Istanbul, Turkey. 6. Department of Urology, Biruni University, Istanbul, Turkey. selcuksilay@gmail.com.
Abstract
OBJECTIVE: To compare the postoperative outcomes including the cosmetic results of robotic-assisted laparoscopic pyeloplasty (RALP) performed with and without assistant port in pediatric population. METHODS: 47 patients with ureteropelvic junction obstruction consecutively underwent RALP were stratified as: three-port (Group 1, n = 26) and four-port (Group 2, n = 21). In Group 1, no assistant port was placed and double-J stent was introduced with the aid of an angiocatheter via the percutaneous route. In group 2, an assistant port was placed. The Patient and Observer Scar Assessment Scale (POSAS), the Vancouver Scar Scale(VSS), Satava, Clavien classification systems, and success rates were compared. RESULTS: We found similar success rates for both groups (group 1:96.2%, group 2:100%). Two groups were similar in terms of improvement in the postoperative anteroposterior diameter of the renal pelvis and parenchymal thickness. There was no difference in terms of perioperative and postoperative complication rates (group 1:19.2%, group 2:9.5%). The total PSAS was significantly lower in Group 1 (p < 0.008). No difference was observed for VSS and OSAS. CONCLUSIONS: Using an assistant port does not improve the success or complications of RALP, while the cosmetic outcomes are inferior to three-port RALP in children. We suggest avoiding the use of assistant port during RALP in children.
OBJECTIVE: To compare the postoperative outcomes including the cosmetic results of robotic-assisted laparoscopic pyeloplasty (RALP) performed with and without assistant port in pediatric population. METHODS: 47 patients with ureteropelvic junction obstruction consecutively underwent RALP were stratified as: three-port (Group 1, n = 26) and four-port (Group 2, n = 21). In Group 1, no assistant port was placed and double-J stent was introduced with the aid of an angiocatheter via the percutaneous route. In group 2, an assistant port was placed. The Patient and Observer Scar Assessment Scale (POSAS), the Vancouver Scar Scale(VSS), Satava, Clavien classification systems, and success rates were compared. RESULTS: We found similar success rates for both groups (group 1:96.2%, group 2:100%). Two groups were similar in terms of improvement in the postoperative anteroposterior diameter of the renal pelvis and parenchymal thickness. There was no difference in terms of perioperative and postoperative complication rates (group 1:19.2%, group 2:9.5%). The total PSAS was significantly lower in Group 1 (p < 0.008). No difference was observed for VSS and OSAS. CONCLUSIONS: Using an assistant port does not improve the success or complications of RALP, while the cosmetic outcomes are inferior to three-port RALP in children. We suggest avoiding the use of assistant port during RALP in children.
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