Robotic ureteral reconstruction for recurrent strictures after prior failed management
Abstract Objectives To describe our multi‐institutional experience with robotic ureteral reconstruction (RUR) in patients who failed prior endoscopic and/or surgical management. Materials and Methods We retrospectively reviewed our Collaborative of Reconstructive Robotic Ureteral Surgery (CORRUS) da...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-05-01
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| Series: | BJUI Compass |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/bco2.224 |
| _version_ | 1797852918058057728 |
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| author | Matthew Lee Ziho Lee Nicklaus Houston David Strauss Randall Lee Aeen M. Asghar Tanner Corse Lee C. Zhao Michael D. Stifelman Daniel D. Eun Collaborative of Reconstructive Robotic Ureteral Surgery (CORRUS) |
| author_facet | Matthew Lee Ziho Lee Nicklaus Houston David Strauss Randall Lee Aeen M. Asghar Tanner Corse Lee C. Zhao Michael D. Stifelman Daniel D. Eun Collaborative of Reconstructive Robotic Ureteral Surgery (CORRUS) |
| author_sort | Matthew Lee |
| collection | DOAJ |
| description | Abstract Objectives To describe our multi‐institutional experience with robotic ureteral reconstruction (RUR) in patients who failed prior endoscopic and/or surgical management. Materials and Methods We 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. Results Overall, 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. Conclusions RUR may be performed with good intermediate‐term outcomes for patients with recurrent strictures after prior failed endoscopic and/or surgical management. |
| first_indexed | 2024-04-09T19:42:06Z |
| format | Article |
| id | doaj.art-71a80c27cab6419881de784e31940170 |
| institution | Directory Open Access Journal |
| issn | 2688-4526 |
| language | English |
| last_indexed | 2024-04-09T19:42:06Z |
| publishDate | 2023-05-01 |
| publisher | Wiley |
| record_format | Article |
| series | BJUI Compass |
| spelling | doaj.art-71a80c27cab6419881de784e319401702023-04-04T05:34:43ZengWileyBJUI Compass2688-45262023-05-014329830410.1002/bco2.224Robotic ureteral reconstruction for recurrent strictures after prior failed managementMatthew Lee0Ziho Lee1Nicklaus Houston2David Strauss3Randall Lee4Aeen M. Asghar5Tanner Corse6Lee C. Zhao7Michael D. Stifelman8Daniel D. Eun9Collaborative of Reconstructive Robotic Ureteral Surgery (CORRUS)Department of Urology Lewis Katz School of Medicine at Temple University Philadelphia Pennsylvania USADepartment of Urology Lewis Katz School of Medicine at Temple University Philadelphia Pennsylvania USADepartment of Urology Lewis Katz School of Medicine at Temple University Philadelphia Pennsylvania USADepartment of Urology Lewis Katz School of Medicine at Temple University Philadelphia Pennsylvania USADepartment of Urology Lewis Katz School of Medicine at Temple University Philadelphia Pennsylvania USADepartment of Urology Lewis Katz School of Medicine at Temple University Philadelphia Pennsylvania USADepartment of Urology Hackensack Meridian School of Medicine Nutley New Jersey USADepartment of Urology New York University Grossman School of Medicine at New York University Langone Medical Center New York New York USADepartment of Urology Hackensack Meridian School of Medicine Nutley New Jersey USADepartment of Urology Lewis Katz School of Medicine at Temple University Philadelphia Pennsylvania USAAbstract Objectives To describe our multi‐institutional experience with robotic ureteral reconstruction (RUR) in patients who failed prior endoscopic and/or surgical management. Materials and Methods We 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. Results Overall, 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. Conclusions RUR may be performed with good intermediate‐term outcomes for patients with recurrent strictures after prior failed endoscopic and/or surgical management.https://doi.org/10.1002/bco2.224buccal mucosa graftrecurrent ureteral stricturerobotic surgical proceduresureteral obstructionureteroplasty |
| spellingShingle | Matthew Lee Ziho Lee Nicklaus Houston David Strauss Randall Lee Aeen M. Asghar Tanner Corse Lee C. Zhao Michael D. Stifelman Daniel D. Eun Collaborative of Reconstructive Robotic Ureteral Surgery (CORRUS) Robotic ureteral reconstruction for recurrent strictures after prior failed management BJUI Compass buccal mucosa graft recurrent ureteral stricture robotic surgical procedures ureteral obstruction ureteroplasty |
| title | Robotic ureteral reconstruction for recurrent strictures after prior failed management |
| title_full | Robotic ureteral reconstruction for recurrent strictures after prior failed management |
| title_fullStr | Robotic ureteral reconstruction for recurrent strictures after prior failed management |
| title_full_unstemmed | Robotic ureteral reconstruction for recurrent strictures after prior failed management |
| title_short | Robotic ureteral reconstruction for recurrent strictures after prior failed management |
| title_sort | robotic ureteral reconstruction for recurrent strictures after prior failed management |
| topic | buccal mucosa graft recurrent ureteral stricture robotic surgical procedures ureteral obstruction ureteroplasty |
| url | https://doi.org/10.1002/bco2.224 |
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