Single-Port vs Multiple-Port Robot-Assisted Laparoscopic Pyeloplasty for the Treatment of Ureteropelvic Junction Obstruction: A Systematic Review and Meta-Analysis

J Endourol. 2023 Jun;37(6):681-687. doi: 10.1089/end.2023.0064.

Abstract

Background: Single-port robot-assisted pyeloplasty (SP-RP) has been performed in recent years. However, the advantages and disadvantages of SP-RP compared with multiple-port robot-assisted pyeloplasty (MP-RP) remain unclear. The purpose of this meta-analysis was to compare the safety and feasibility of the two technologies. Materials and Methods: Through a literature search using MEDLINE, EMBASE, and the Cochrane Library, studies comparing SP-RP and MP-RP were identified for meta-analysis. Comparisons of perioperative and postoperative outcomes between the groups were analyzed using weighted mean difference (WMD) and risk ratio. Results: Five retrospective cohort studies with 179 patients were included in this meta-analysis. The results showed that SP-RP was associated with shorter hospital stay (WMD: -0.6 minutes, 95% confidence interval [CI]: -1.19 to -0.02, p = 0.04), less postoperative pain (pain score, WMD: -0.84, 95% CI: -1.62 to -0.07, p = 0.03), and superior cosmetic appearance compared with MP-RP. In addition, no differences were found between the SP-RP and MP-RP groups in terms of operative time, blood loss, rate of complications, and recovery of renal function. Conclusion: SP-RP provided comparable effectiveness, safety, and superior outcomes in terms of cosmetic appearance and pain compared with MP-RP, which gives surgeons the confidence to adopt and promote these ultraminimal invasive surgeries.

Keywords: pyeloplasty; robotic surgery; single port; ureteropelvic junction obstruction.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Humans
  • Kidney / physiology
  • Kidney Pelvis / surgery
  • Laparoscopy* / methods
  • Pain / etiology
  • Retrospective Studies
  • Robotic Surgical Procedures*
  • Robotics*
  • Treatment Outcome
  • Ureteral Obstruction* / etiology
  • Ureteral Obstruction* / surgery
  • Urologic Surgical Procedures / methods