Ureteral Rest is Associated With Improved Outcomes in Patients Undergoing Robotic Ureteral Reconstruction of Proximal and Middle Ureteral Strictures
| Autor: | Ravi Munver, Min Jun, Lee C. Zhao, Ziho Lee, Daniel Eun, Nathan Cheng, Helaine Koster, Michael D. Stifelman, Randall A. Lee, Matthew Lee, Mutahar Ahmed, Michael Siev |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Percutaneous urogenital system business.industry Urology medicine.medical_treatment 030232 urology & nephrology Stent Perioperative urologic and male genital diseases female genital diseases and pregnancy complications Ureteral reconstruction Surgery 03 medical and health sciences surgical procedures operative 0302 clinical medicine Blood loss 030220 oncology & carcinogenesis medicine In patient Ureteral Stricture business Rest (music) |
| Zdroj: | Urology. 152:160-166 |
| ISSN: | 0090-4295 |
| Popis: | Objectives To evaluate the effect of ureteral rest on outcomes of robotic ureteral reconstruction. Methods We retrospectively reviewed all patients who underwent robotic ureteral reconstruction of proximal and/or middle ureteral strictures in our multi-institutional database between 2/2012—03/2019 with ≥12 months follow-up. All patients were recommended to undergo ureteral rest, which we defined as the absence of hardware (ie. double-J stent or percutaneous nephroureteral tube) across a ureteral stricture ≥4 weeks prior to reconstruction. However, patients who refused percutaneous nephrostomy tube placement did not undergo ureteral rest. Perioperative outcomes were compared after grouping patients according to whether or not they underwent ureteral rest. Continuous and categorical variables were compared using Mann-Whitney U and 2-tailed chi-squared tests, respectively; P Results Of 234 total patients, 194 (82.9%) underwent ureteral rest and 40 (17.1%) did not undergo ureteral rest prior to ureteral reconstruction. Patients undergoing ureteral rest were associated with a higher success rate compared to those not undergoing ureteral rest (90.7% versus 77.5%, respectively; P = .027). Also, patients undergoing ureteral rest were associated with lower estimated blood loss (50 versus 75 milliliters, respectively; p Conclusions Implementing ureteral rest prior to ureteral reconstruction may allow for stricture maturation and is associated higher surgical success rates, lower estimated blood loss, and decreased utilization of buccal mucosa graft ureteroplasty. |
| Databáze: | OpenAIRE |
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