Single-Port Versus Multiport Robot-Assisted Laparoscopic Pyeloplasty in Children With Ureteropelvic Junction Obstruction: A Systematic Review and Meta-Analysis

Abstract

Objective: To compare perioperative and clinical outcomes between single-port robot-assisted laparoscopic pyeloplasty and multiport robot-assisted laparoscopic pyeloplasty in children with ureteropelvic junction obstruction.

Data source: A systematic search of PubMed and Scopus was conducted from database inception to the final search date. Randomized and non-randomized comparative studies involving children younger than 18 years with ureteropelvic junction obstruction were eligible. Outcomes included operative time, length of hospital stay, estimated blood loss, surgical success, postoperative pain, and cosmetic satisfaction.

Data synthesis: Seven comparative studies were included. Meta-analysis was feasible for operative time and length of hospital stay. No significant difference was found in operative time (standardized mean difference, 1.09; 95% confidence interval, −1.99 to 4.17; I² = 97%) or length of hospital stay (standardized mean difference, 0.25; 95% confidence interval, −0.24 to 0.75; I² = 8%). Estimated blood loss could not be quantitatively pooled because of inconsistent reporting, although both approaches generally demonstrated low blood loss. Surgical success rates were high for both techniques, ranging from 94.1% to 100% for multiport procedures and reaching 100% among reported single-port cases. One study reported higher cosmetic satisfaction with the single-port approach (9.40 ± 0.52 versus 8.39 ± 0.92).

Conclusion: Single-port and multiport robot-assisted laparoscopic pyeloplasty demonstrated comparable perioperative outcomes and high surgical success in children with ureteropelvic junction obstruction. The single-port approach may provide better cosmetic satisfaction, although the available evidence remains limited. Further prospective comparative studies are warranted.