Abstract / Summary
Calyceal diverticula (CD) are outpouchings of the pelvicalyceal system into the renal parenchyma. The purpose of this systematic review is to summarize the outcomes associated with laparoscopic and robotic-assisted approaches for the management of symptomatic CD.
Our findings were structured according to the PRISMA statement. We queried three electronic databases, PubMed, Cochrane Library, and Web of Science, to systematically review the literature. Relying on the March 2009 guidelines from the Oxford Centre for Evidence-Based Medicine, two authors independently judged the quality and evidence level of the final articles.
Nine studies were included in final qualitative synthesis. The operative time ranged from 80 to 172 (107-197) minutes, while Estimated Blood Loss ranged from 40 (5-100) to 150 (50-300) ml. The Grade I-II complications according to Clavien-Dindo Classification System ranged from 0% to 66.7%, while no Grade III-IV complications were reported in either of the nine studies. The rate of patients reporting flank pain recurrence during the follow-up period ranged from 0% to 28.5%, while recurrence of the diverticulum ranged from 0% to 33.3%. None of the patients with flank pain or diverticulum recurrence needed a reoperation.
The findings of this systematic review suggest that laparoscopic and robotic approaches are feasible and have shown favorable outcomes in selected patients with symptomatic CD, particularly in cases with complex anatomy or after failed endourological treatment. However, the available evidence remains limited.