Minimally invasive ureteroplasty with lingual mucosal graft for complex ureteral stricture: analysis of surgical and patient-reported outcomes
ABSTRACT Objective: To evaluate objective treatment efficacy and safety, and subjective patient-reported outcomes in patients with complex ureteral strictures (US) undergoing minimally invasive lingual mucosal graft ureteroplasty (LMGU). Materials and Methods: We prospectively enrolled patients un...
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| Format: | Article |
| Language: | English |
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Sociedade Brasileira de Urologia
2024-04-01
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| Series: | International Brazilian Journal of Urology |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382024000100046&lng=en&tlng=en |
| _version_ | 1797216752973643776 |
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| author | Xiang Wang Chang Meng Derun Li Yicen Ying Yunke Ma Shubo Fan Xinfei Li Kunlin Yang Bing Wang Hua Guan Peng Zhang Jing Liu Chen Huang Hongjian Zhu Kai Zhang Liqun Zhou Zhihua Li Xuesong Li |
| author_facet | Xiang Wang Chang Meng Derun Li Yicen Ying Yunke Ma Shubo Fan Xinfei Li Kunlin Yang Bing Wang Hua Guan Peng Zhang Jing Liu Chen Huang Hongjian Zhu Kai Zhang Liqun Zhou Zhihua Li Xuesong Li |
| author_sort | Xiang Wang |
| collection | DOAJ |
| description | ABSTRACT Objective: To evaluate objective treatment efficacy and safety, and subjective patient-reported outcomes in patients with complex ureteral strictures (US) undergoing minimally invasive lingual mucosal graft ureteroplasty (LMGU). Materials and Methods: We prospectively enrolled patients underwent robotic or laparoscopic LMGU between May 2020 and July 2022. Clinical success was defined as symptom-free and no radiographic evidence of re-obstruction. Patient-reported outcomes, including health-related quality of life (HRQoL), mental health status and oral health-related quality of life (OHRQoL), were longitudinally evaluated before surgery, 6 and 12 months postoperatively. Results: Overall, 41 consecutive patients were included. All procedures were performed successfully with 32 patients in robotic approach and 9 in laparoscopic. Forty (97.56%) patients achieved clinical success during the median follow-up of 29 (range 15-41) months. Although patients with complex US experienced poor baseline HRQoL, there was a remarkable improvement following LMGU. Specifically, the 6-month and 12-month postoperative scores were significantly improved compared to the baseline (p < 0.05) in most domains. Twenty-eight (68.3%) and 31 (75.6%) patients had anxiety and depression symptoms before surgery, respectively. However, no significant decrease in the incidence of these symptoms was observed postoperatively. Moreover, there was no significant deterioration of OHRQoL at 6 months and 12 months postoperatively when compared to the baseline. Conclusions: LMGU is a safe and efficient procedure for complex ureteral reconstruction that significantly improves patient-reported HRQoL without compromising OHRQoL. Assessing patients’ quality of life enables us to monitor postoperative recovery and progress, which should be considered as one of the criteria for surgical success. |
| first_indexed | 2024-04-24T11:50:58Z |
| format | Article |
| id | doaj.art-33dabd6a23104dae9a7f2a0ce9f40f52 |
| institution | Directory Open Access Journal |
| issn | 1677-6119 |
| language | English |
| last_indexed | 2024-04-24T11:50:58Z |
| publishDate | 2024-04-01 |
| publisher | Sociedade Brasileira de Urologia |
| record_format | Article |
| series | International Brazilian Journal of Urology |
| spelling | doaj.art-33dabd6a23104dae9a7f2a0ce9f40f522024-04-09T07:46:17ZengSociedade Brasileira de UrologiaInternational Brazilian Journal of Urology1677-61192024-04-01501465710.1590/s1677-5538.ibju.2023.0393Minimally invasive ureteroplasty with lingual mucosal graft for complex ureteral stricture: analysis of surgical and patient-reported outcomesXiang Wanghttps://orcid.org/0000-0002-2923-1828Chang MengDerun LiYicen YingYunke MaShubo FanXinfei LiKunlin YangBing WangHua GuanPeng ZhangJing LiuChen HuangHongjian ZhuKai ZhangLiqun ZhouZhihua LiXuesong LiABSTRACT Objective: To evaluate objective treatment efficacy and safety, and subjective patient-reported outcomes in patients with complex ureteral strictures (US) undergoing minimally invasive lingual mucosal graft ureteroplasty (LMGU). Materials and Methods: We prospectively enrolled patients underwent robotic or laparoscopic LMGU between May 2020 and July 2022. Clinical success was defined as symptom-free and no radiographic evidence of re-obstruction. Patient-reported outcomes, including health-related quality of life (HRQoL), mental health status and oral health-related quality of life (OHRQoL), were longitudinally evaluated before surgery, 6 and 12 months postoperatively. Results: Overall, 41 consecutive patients were included. All procedures were performed successfully with 32 patients in robotic approach and 9 in laparoscopic. Forty (97.56%) patients achieved clinical success during the median follow-up of 29 (range 15-41) months. Although patients with complex US experienced poor baseline HRQoL, there was a remarkable improvement following LMGU. Specifically, the 6-month and 12-month postoperative scores were significantly improved compared to the baseline (p < 0.05) in most domains. Twenty-eight (68.3%) and 31 (75.6%) patients had anxiety and depression symptoms before surgery, respectively. However, no significant decrease in the incidence of these symptoms was observed postoperatively. Moreover, there was no significant deterioration of OHRQoL at 6 months and 12 months postoperatively when compared to the baseline. Conclusions: LMGU is a safe and efficient procedure for complex ureteral reconstruction that significantly improves patient-reported HRQoL without compromising OHRQoL. Assessing patients’ quality of life enables us to monitor postoperative recovery and progress, which should be considered as one of the criteria for surgical success.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382024000100046&lng=en&tlng=enMinimally Invasive Surgical ProceduresPlastic Surgery ProceduresQuality of Life |
| spellingShingle | Xiang Wang Chang Meng Derun Li Yicen Ying Yunke Ma Shubo Fan Xinfei Li Kunlin Yang Bing Wang Hua Guan Peng Zhang Jing Liu Chen Huang Hongjian Zhu Kai Zhang Liqun Zhou Zhihua Li Xuesong Li Minimally invasive ureteroplasty with lingual mucosal graft for complex ureteral stricture: analysis of surgical and patient-reported outcomes International Brazilian Journal of Urology Minimally Invasive Surgical Procedures Plastic Surgery Procedures Quality of Life |
| title | Minimally invasive ureteroplasty with lingual mucosal graft for complex ureteral stricture: analysis of surgical and patient-reported outcomes |
| title_full | Minimally invasive ureteroplasty with lingual mucosal graft for complex ureteral stricture: analysis of surgical and patient-reported outcomes |
| title_fullStr | Minimally invasive ureteroplasty with lingual mucosal graft for complex ureteral stricture: analysis of surgical and patient-reported outcomes |
| title_full_unstemmed | Minimally invasive ureteroplasty with lingual mucosal graft for complex ureteral stricture: analysis of surgical and patient-reported outcomes |
| title_short | Minimally invasive ureteroplasty with lingual mucosal graft for complex ureteral stricture: analysis of surgical and patient-reported outcomes |
| title_sort | minimally invasive ureteroplasty with lingual mucosal graft for complex ureteral stricture analysis of surgical and patient reported outcomes |
| topic | Minimally Invasive Surgical Procedures Plastic Surgery Procedures Quality of Life |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382024000100046&lng=en&tlng=en |
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