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Tytuł pozycji:

Intermediate-term outcomes after robotic ureteral reconstruction for long-segment (≥4 centimeters) strictures in the proximal ureter: A multi-institutional experience.

Tytuł :
Intermediate-term outcomes after robotic ureteral reconstruction for long-segment (≥4 centimeters) strictures in the proximal ureter: A multi-institutional experience.
Autorzy :
Lee, Matthew
Ziho Lee
Koster, Helaine
Minsuk Jun
Asghar, Aeen M.
Lee, Randall
Strauss, David
Patel, Neel
Kim, Daniel
Komaravolu, Sreeya
Drain, Alice
Metro, Michael J.
Lee Zhao
Stifelman, Michael
Eun, Daniel D.
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Temat :
URETERIC obstruction
URETER surgery
URETERS
ROBOTICS
SURGICAL robots
URETHROPLASTY
URETEROSCOPY
Źródło :
Investigative & Clinical Urology; Jan2021, Vol. 62 Issue 1, p65-71, 7p
Czasopismo naukowe
Purpose: To report our intermediate-term, multi-institutional experience after robotic ureteral reconstruction for the management of long-segment proximal ureteral strictures. Materials and Methods: We retrospectively reviewed our Collaborative of Reconstructive Robotic Ureteral Surgery (CORRUS) database to identify all patients who underwent robotic ureteral reconstruction for long-segment (≥4 centimeters) proximal ureteral strictures between August 2012 and June 2019. The primary surgeon determined the specific technique to reconstruct the ureter at time of surgery based on the patient's clinical history and intraoperative findings. Our primary outcome was surgical success, which we defined as the absence of ureteral obstruction on radiographic imaging and absence of obstructive flank pain. Results: Of 20 total patients, 4 (20.0%) underwent robotic ureteroureterostomy (RUU) with downward nephropexy (DN), 2 (10.0%) underwent robotic ureterocalycostomy (RUC) with DN, and 14 (70.0%) underwent robotic ureteroplasty with buccal mucosa graft (RU-BMG). Median stricture length was 4 centimeters (interquartile range [IQR], 4--4; maximum, 5), 6 centimeters (IQR, 5--7; maximum, 8), and 5 centimeters (IQR, 4--5; maximum, 8) for patients undergoing RUU with DN, RUC with DN, and RU-BMG, respectively. At a median follow-up of 24 (IQR, 14--51) months, 17/20 (85.0%) cases were surgically successful. Two of four patients (50.0%) who underwent RUU with DN developed stricture recurrences within 3 months. Conclusions: Long-segment proximal ureteral strictures may be safely and effectively managed with RUC with DN and RU-BMG. Although RUU with DN can be utilized, this technique may be associated with a higher failure rate. [ABSTRACT FROM AUTHOR]
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