Affiliation:
1. Department of Urology Lewis Katz School of Medicine at Temple University Philadelphia Pennsylvania USA
2. Department of Urology Hackensack Meridian School of Medicine Nutley New Jersey USA
3. Department of Urology New York University Grossman School of Medicine at New York University Langone Medical Center New York New York USA
Abstract
AbstractObjectivesTo describe our multi‐institutional experience with robotic ureteral reconstruction (RUR) in patients who failed prior endoscopic and/or surgical management.Materials and MethodsWe retrospectively reviewed our Collaborative of Reconstructive Robotic Ureteral Surgery (CORRUS) database for all consecutive patients who underwent RUR between 05/2012 and 01/2020 for a recurrent ureteral stricture after having undergone prior failed endoscopic and/or surgical repair. Post‐operatively, patients were assessed for surgical success, defined as the absence of flank pain and obstruction on imaging.ResultsOverall, 105 patients met inclusion criteria. Median stricture length was 2 (IQR 1–3) centimetres. Strictures were located at the ureteropelvic junction (UPJ) (41.0%), proximal (14.3%), middle (9.5%) or distal (35.2%) ureter. There were nine (8.6%) radiation‐induced strictures. Prior failed management included endoscopic intervention (49.5%), surgical repair (25.7%) or both (24.8%). For repair of UPJ and proximal strictures, ureteroureterostomy (3.4%), ureterocalicostomy (5.2%), pyeloplasty (53.5%) or buccal mucosa graft ureteroplasty (37.9%) was utilized; for repair of middle strictures, ureteroureterostomy (20.0%) or buccal mucosa graft ureteroplasty (80.0%) was utilized; for repair of distal strictures, ureteroureterostomy (8.1%), side‐to‐side reimplant (18.9%), end‐to‐end reimplant (70.3%) or appendiceal bypass (2.7%) was utilized. Major (Clavien >2) post‐operative complications occurred in two (1.9%) patients. At a median follow‐up of 15.1 (IQR 5.0–30.4) months, 94 (89.5%) cases were surgically successful.ConclusionsRUR may be performed with good intermediate‐term outcomes for patients with recurrent strictures after prior failed endoscopic and/or surgical management.
Subject
Religious studies,Cultural Studies
Cited by
2 articles.
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