{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T17:57:58Z","timestamp":1781719078876,"version":"3.54.5"},"reference-count":28,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:00:00Z","timestamp":1781654400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100017577","name":"Basic Public Welfare Research Program of Zhejiang Province","doi-asserted-by":"publisher","award":["LGF22H050004"],"award-info":[{"award-number":["LGF22H050004"]}],"id":[{"id":"10.13039\/501100017577","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to evaluate the efficacy of robot-assisted reconstruction using end-to-side ureteroureterostomy (UU) and Lich\u2012Gregoir ureterovesical reimplantation (UR) for complicated duplex kidneys in children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective study was conducted on pediatric patients who underwent combined robotic UU and Lich\u2012Gregoir UR between January 1, 2021, and January 1, 2024. The inclusion criterion was the presence of concurrent upper- and lower-pole ureteral pathologies. Surgical time, postoperative length of stay, pre- and postoperative anteroposterior diameter of the renal pelvis (APD), ureteral diameter (UD), renal function (RF) of the affected kidney, and complications were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In total, 12 patients presented with urinary tract infections (UTI, n\u2009=\u20099), incontinence (n\u2009=\u20092), and abdominal pain (n\u2009=\u20091). Upper-pole pathologies included ectopic ureters (10 cases) and ureteroceles (2 cases). Lower-pole pathologies comprised ureteral stricture (n\u2009=\u20094) and vesicoureteral reflux (VUR, n\u2009=\u20098). The median surgical time was 177.5 minutes (range: 140\u2013205 minutes), and the median hospital stay was 5 days (range: 3\u20137 days). Postoperative complications included two cases of UTI, both managed conservatively. At a median follow-up of 19 months (range: 12\u201331 months), no anastomotic stricture, urinary leakage, or ureteral stump syndrome occurred. Postoperative voiding cystourethrogram (VCUG) revealed no VUR in any patient. Pre- and postoperative APD (22.92\u2009\u00b1\u20099.07 mm vs. 7.33\u2009\u00b1\u20095.03 mm, p\u2009&lt;\u20090.001) and UD (11.08\u2009\u00b1\u20093.15 vs. 5.83\u2009\u00b1\u20092.41 mm, p\u2009&lt;\u20090.001) differed significantly in the upper pole system, as did the lower pole APD (14.00\u2009\u00b1\u20096.25 vs. 5.25\u2009\u00b1\u20093.02 mm, p\u2009&lt;\u20090.001) and UD (7.75\u2009\u00b1\u20092.26 vs. 4.75\u2009\u00b1\u20091.36 mm, p\u2009=\u20090.003). The RF of the affected moiety improved significantly (36.58\u2009\u00b1\u20094.66% vs. 42.75%\u2009\u00b1\u20093.10%, p\u2009&lt;\u20090.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Robot-assisted reconstruction using UU and Lich\u2013Gregoir UR is a safe and effective approach for complex duplex kidneys requiring concurrent upper- and lower-tract reconstruction, demonstrating durable resolution of obstruction and reflux as well as functional preservation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0351941","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T17:26:27Z","timestamp":1781717187000},"page":"e0351941","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Robot-assisted reconstruction using ureteroureterostomy and Lich\u2013Gregoir ureteral reimplantation for complicated duplex kidneys in children"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-0274-2800","authenticated-orcid":true,"given":"Huazhang","family":"Liu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang","family":"Tao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiang","family":"Yan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guangjie","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6265-8399","authenticated-orcid":true,"given":"Guangping","family":"Zeng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,6,17]]},"reference":[{"issue":"3","key":"pone.0351941.ref001","doi-asserted-by":"crossref","DOI":"10.1016\/j.jpurol.2024.01.008","article-title":"Results 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Zhu","year":"2021","journal-title":"Transl Pediatr"},{"issue":"1","key":"pone.0351941.ref011","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1007\/s00383-024-05908-5","article-title":"A comparative study on the efficacy of laparoscopic ureteroureterostomy versus single ureteral bladder reimplantation in treating pediatric complete renal duplication","volume":"41","author":"B Yu","year":"2024","journal-title":"Pediatr Surg Int"},{"issue":"4","key":"pone.0351941.ref012","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.1007\/s00345-022-03929-0","article-title":"Laparoscopic and robotic pyeloplasty as minimally invasive alternatives to the open approach for the treatment of uretero-pelvic junction obstruction in infants: A multi-institutional comparison of outcomes and learning curves","volume":"40","author":"C Andolfi","year":"2022","journal-title":"World J 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