Perioperative and functionnal outcomes of robot-assisted laparoscopic versus open ureterovesical reimplantation for benign lower ureteral pathologies: a single-center comparative study.

IF 2.8 2区医学 Q2 UROLOGY & NEPHROLOGY

World Journal of Urology Pub Date : 2024-10-17 DOI:10.1007/s00345-024-05269-7

Anthony Kanbar, Ugo Pinar, Louis Lenfant, Jérome Parra, Christophe Vaessen, Sarah Drouin, Pierre Mozer, Aurélien Beaugerie, Emmanuel Chartier-Kastler, Morgan Roupret, Thomas Seisen

{"title":"Perioperative and functionnal outcomes of robot-assisted laparoscopic versus open ureterovesical reimplantation for benign lower ureteral pathologies: a single-center comparative study.","authors":"Anthony Kanbar, Ugo Pinar, Louis Lenfant, Jérome Parra, Christophe Vaessen, Sarah Drouin, Pierre Mozer, Aurélien Beaugerie, Emmanuel Chartier-Kastler, Morgan Roupret, Thomas Seisen","doi":"10.1007/s00345-024-05269-7","DOIUrl":null,"url":null,"abstract":"Purpose: The robot-assisted laparoscopic (RALUVR) and open (OUVR) approaches have both been described for ureterovesical reimplantation to treat benign lower ureteral pathologies. Thus, we aimed to compare the perioperative and functional outcomes of RALUVR vs. OUVR.Methods: We performed a retrospective comparative study including all consecutive patients treated with RALUVR or OUVR for benign lower ureteral pathologies between January 2013 and December 2022 at our center. Logistic regression analyses were used to assess the predictors of complication ≥ Clavien-Dindo (CD) III within 90 days, prolonged length of stay (LOS), and 90-day overall success. The Kaplan-Meier method and Cox regression analyses were used to assess vesicoureteral reflux-free (VU-RFS) and stenosis-free (SFS) survivals.Results: Overall, 44 patients underwent RALUVR (n = 19; 43%) and OUVR (n = 25; 57%). In univariable logistic regression analyses, the use of RALUVR vs. OUVR was not significantly associated with postoperative complications ≥ CDIII (OR = 0.98; 95% CI=[0.17-5.09]; p = 0.98), and 90-day overall success (OR = 1.43; 95% CI=[0.24-11.28]; p = 0.7). Despite a shorter median LOS after RALUVR vs. OUVR (4 vs. 10 days, respectively; p < 0.001), multivariable logistic regression analysis showed no impact of the surgical approach on prolonged LOS (OR = 0.51, 95% CI=[0.03-13.86]; p = 0.65). No significant difference was observed in 2-year VU-RFS (72.9% vs. 100%, respectively; p = 0.2) and 2-year SFS between the RALUVR and OUVR groups (85.7% vs. 87.7%, respectively; p = 0.8). In Cox regression analysis, the use of RALUVR vs. OUVR was not significantly associated with VU-RFS (HR = 4.26; 95% CI=[0.38-47.84]; p = 0.24) or SFS (HR = 1.32; 95% CI=[0.22-8.01]; p = 0.76).Conclusion: We observed that RALUVR provides similar perioperative and functional outcomes as compared to OUVR, except for potentially shorter LOS.","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"42 1","pages":"580"},"PeriodicalIF":2.8000,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"World Journal of Urology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00345-024-05269-7","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose: The robot-assisted laparoscopic (RALUVR) and open (OUVR) approaches have both been described for ureterovesical reimplantation to treat benign lower ureteral pathologies. Thus, we aimed to compare the perioperative and functional outcomes of RALUVR vs. OUVR.

Methods: We performed a retrospective comparative study including all consecutive patients treated with RALUVR or OUVR for benign lower ureteral pathologies between January 2013 and December 2022 at our center. Logistic regression analyses were used to assess the predictors of complication ≥ Clavien-Dindo (CD) III within 90 days, prolonged length of stay (LOS), and 90-day overall success. The Kaplan-Meier method and Cox regression analyses were used to assess vesicoureteral reflux-free (VU-RFS) and stenosis-free (SFS) survivals.

Results: Overall, 44 patients underwent RALUVR (n = 19; 43%) and OUVR (n = 25; 57%). In univariable logistic regression analyses, the use of RALUVR vs. OUVR was not significantly associated with postoperative complications ≥ CDIII (OR = 0.98; 95% CI=[0.17-5.09]; p = 0.98), and 90-day overall success (OR = 1.43; 95% CI=[0.24-11.28]; p = 0.7). Despite a shorter median LOS after RALUVR vs. OUVR (4 vs. 10 days, respectively; p < 0.001), multivariable logistic regression analysis showed no impact of the surgical approach on prolonged LOS (OR = 0.51, 95% CI=[0.03-13.86]; p = 0.65). No significant difference was observed in 2-year VU-RFS (72.9% vs. 100%, respectively; p = 0.2) and 2-year SFS between the RALUVR and OUVR groups (85.7% vs. 87.7%, respectively; p = 0.8). In Cox regression analysis, the use of RALUVR vs. OUVR was not significantly associated with VU-RFS (HR = 4.26; 95% CI=[0.38-47.84]; p = 0.24) or SFS (HR = 1.32; 95% CI=[0.22-8.01]; p = 0.76).

Conclusion: We observed that RALUVR provides similar perioperative and functional outcomes as compared to OUVR, except for potentially shorter LOS.

查看原文本刊更多论文

针对良性输尿管下段病变的机器人辅助腹腔镜输尿管再植术与开腹输尿管再植术的围手术期和功能结果：一项单中心比较研究。

目的：机器人辅助腹腔镜（RALUVR）和开放式（OUVR）输尿管再植术均用于治疗输尿管下段良性病变。因此，我们旨在比较 RALUVR 与 OUVR 的围手术期和功能结果：我们进行了一项回顾性比较研究，包括 2013 年 1 月至 2022 年 12 月在本中心接受 RALUVR 或 OUVR 治疗的所有输尿管下段良性病变的连续患者。采用逻辑回归分析评估90天内并发症≥Clavien-Dindo（CD）Ⅲ、住院时间（LOS）延长和90天总体成功率的预测因素。采用 Kaplan-Meier 法和 Cox 回归分析评估无膀胱输尿管反流（VU-RFS）和无狭窄（SFS）存活率：共有 44 名患者接受了 RALUVR（19 人；43%）和 OUVR（25 人；57%）。在单变量逻辑回归分析中，使用 RALUVR 与 OUVR 与术后并发症≥ CDIII（OR=0.98；95% CI=[0.17-5.09]；P=0.98）和 90 天总体成功率（OR=1.43；95% CI=[0.24-11.28]；P=0.7）无显著相关性。尽管 RALUVR 与 OUVR 相比，中位 LOS 更短（分别为 4 天与 10 天；P 结论：RALUVR 与 OUVR 相比，中位 LOS 更短：我们观察到，RALUVR 与 OUVR 相比，除了 LOS 可能更短之外，其围手术期和功能结果相似。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

World Journal of Urology 医学-泌尿学与肾脏学

CiteScore

6.80

自引率

8.80%

发文量

317

审稿时长

4-8 weeks

期刊介绍： The WORLD JOURNAL OF UROLOGY conveys regularly the essential results of urological research and their practical and clinical relevance to a broad audience of urologists in research and clinical practice. In order to guarantee a balanced program, articles are published to reflect the developments in all fields of urology on an internationally advanced level. Each issue treats a main topic in review articles of invited international experts. Free papers are unrelated articles to the main topic.