A Multi-Institutional Experience With Robotic Ureteroplasty With Buccal Mucosa Graft: An Updated Analysis of Intermediate-Term Outcomes.

Autor: Lee Z; Department of Urology, Lewis Katz School of Medicine at Temple University, Philadelphia, PA. Electronic address: Ziho.Lee@gmail.com., Lee M; Department of Urology, Lewis Katz School of Medicine at Temple University, Philadelphia, PA., Koster H; Department of Urology, Hackensack Meridian School of Medicine at Seton Hall University, Hackensack, NJ., Lee R; Department of Urology, Lewis Katz School of Medicine at Temple University, Philadelphia, PA., Cheng N; Department of Urology, Hackensack Meridian School of Medicine at Seton Hall University, Hackensack, NJ., Jun M; Department of Urology, Grossman School of Medicine at New York University Langone Health, New York, NY., Slawin J; Department of Urology, Grossman School of Medicine at New York University Langone Health, New York, NY., Zhao LC; Department of Urology, Grossman School of Medicine at New York University Langone Health, New York, NY., Stifelman MD; Department of Urology, Hackensack Meridian School of Medicine at Seton Hall University, Hackensack, NJ., Eun DD; Department of Urology, Lewis Katz School of Medicine at Temple University, Philadelphia, PA.
Jazyk: angličtina
Zdroj: Urology [Urology] 2021 Jan; Vol. 147, pp. 306-310. Date of Electronic Publication: 2020 Aug 13.
DOI: 10.1016/j.urology.2020.08.003
Abstrakt: Objective: To update our prior multi-institutional experience with robotic ureteroplasty with buccal mucosa graft and analyze our intermediate-term outcomes. Although our previous multi-institutional report provided significant insight into the safety and efficacy associated with robotic ureteroplasty with buccal mucosa graft, it was limited by small patient numbers.
Methods: We retrospectively reviewed our multi-institutional database to identify all patients who underwent robotic ureteroplasty with buccal mucosa graft between October 2013 and March 2019 with ≥12 months follow up. Indication for surgery was a complex proximal and/or middle ureteral stricture not amenable to primary excision and anastomosis secondary to stricture length or peri-ureteral fibrosis. Surgical success was defined as the absence of obstructive flank pain and ureteral obstruction on functional imaging.
Results: Of 54 patients, 43 (79.6 %) patients underwent an onlay, and 11 (20.4%) patients underwent an augmented anastomotic robotic ureteroplasty with buccal mucosa graft. Eighteen of 54 (33.3%) patients previously failed a ureteral reconstruction. The median stricture length was 3.0 (IQR 2.0-4.0, range 1-8) centimeters. There were 3 of 54 (5.6%) major postoperative complications. The median length of stay was 1.0 (IQR 1.0-3.0) day. At a median follow-up of 27.5 (IQR 21.3-38.0) months, 47 of 54 (87.0%) cases were surgically successful. Stricture recurrences were diagnosed ≤2 months postoperatively in 3 of 7 (42.9%) patients, and ≥10 months postoperatively in 4 of 7 (57.1%) patients.
Conclusion: Robotic ureteroplasty with buccal mucosa graft is associated with low peri-operative morbidity and excellent intermediate-term outcomes.
(Copyright © 2020 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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