Elizabeth N Bearrick, Bridget L Findlay, Anthony Fadel, Aaron M Potretzke, Katherine T Anderson, Boyd R Viers
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Clinical characteristics, complications, reconstructive success (uretero-enteric patency), need for repeat intervention, and renal function were assessed in patients undergoing open and robotic UES reconstruction. <b><i>Results:</i></b> Of 50 patients undergoing UES repair during the study period, 45 were included for analysis due to complete follow-up (34 [76%] robotic and 11 [24%] open repair). UES repair was performed in 50 renal units a median of 13 months (interquartile range 7-30) from index surgery, and most often involved the left renal unit (34/50; 68%). Compared with robotic, open cases were significantly more likely to have undergone open cystectomy (100% <i>vs</i> 68%, <i>p</i> = 0.04), have longer strictures (median 4 <i>vs</i> 1 cm, <i>p</i> < 0.001), require tissue substitution (27% <i>vs</i> 3%, <i>p</i> = 0.04), and have lengthier postoperative hospitalization (5 <i>vs</i> 2 days, <i>p</i> < 0.001). There was no significant difference in total operative time (410 <i>vs</i> 322 minutes) or 30d major complications (18% <i>vs</i> 21%). At a follow-up of 13 months, per patient reconstructive success was 100% (11/11) for open and 97% (33/34) for robotic, respectively. <b><i>Conclusion:</i></b> In select patients with short UES unlikely to require advanced reconstructive techniques, a robotic-assisted approach can be considered. Careful patient selection is associated with limited morbidity and high reconstructive success.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":null,"pages":null},"PeriodicalIF":2.9000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Open and Robotic Uretero-enteric Stricture Repair: Early Outcomes and Complications.\",\"authors\":\"Elizabeth N Bearrick, Bridget L Findlay, Anthony Fadel, Aaron M Potretzke, Katherine T Anderson, Boyd R Viers\",\"doi\":\"10.1089/end.2024.0021\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b><i>Objective:</i></b> To characterize our single institutional experience with robotic and open uretero-enteric stricture (UES) repair. <b><i>Materials and Methods:</i></b> We queried our ureteral reconstructive database for UES repair between 01/2017 and 10/2023. Patients with <3 months follow-up were excluded. Prior to surgery, patients underwent ureteral rest (4 weeks) with conversion to nephrostomy tube. Clinical characteristics, complications, reconstructive success (uretero-enteric patency), need for repeat intervention, and renal function were assessed in patients undergoing open and robotic UES reconstruction. <b><i>Results:</i></b> Of 50 patients undergoing UES repair during the study period, 45 were included for analysis due to complete follow-up (34 [76%] robotic and 11 [24%] open repair). UES repair was performed in 50 renal units a median of 13 months (interquartile range 7-30) from index surgery, and most often involved the left renal unit (34/50; 68%). 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引用次数: 0
摘要
摘要总结我们单个机构在机器人和开放式输尿管肠管狭窄(UES)修复方面的经验:我们在输尿管重建数据库中查询了 2017 年 1 月至 2023 年 10 月期间的 UES 修复情况。随访<3个月的患者被排除在外。手术前,患者进行了输尿管休息(4周),并转换为肾造瘘管。对接受开放式和机器人输尿管ES重建术的患者的临床特征、并发症、重建成功率(输尿管-肠管通畅率)、重复干预需求和肾功能进行了评估:在研究期间接受 UES 修复术的 50 名患者中,有 45 人因随访完整而纳入分析(34 人[76%]接受机器人修复术,11 人[24%]接受开放式修复术)。在50个肾单位进行了UES修复术,中位时间为手术后13个月(IQR 7-30),最常涉及的是左肾单位(34/50;68%)。与机器人手术相比,开放手术病例更有可能接受过开放性膀胱切除术(100% vs 68%,P=0.04),狭窄时间更长(中位 4 cm vs 1 cm,P=0.04):对于一些不太需要先进重建技术的短膀胱尿道患者,可以考虑采用机器人辅助方法。对患者的精心选择可降低发病率,提高重建成功率。
Open and Robotic Uretero-enteric Stricture Repair: Early Outcomes and Complications.
Objective: To characterize our single institutional experience with robotic and open uretero-enteric stricture (UES) repair. Materials and Methods: We queried our ureteral reconstructive database for UES repair between 01/2017 and 10/2023. Patients with <3 months follow-up were excluded. Prior to surgery, patients underwent ureteral rest (4 weeks) with conversion to nephrostomy tube. Clinical characteristics, complications, reconstructive success (uretero-enteric patency), need for repeat intervention, and renal function were assessed in patients undergoing open and robotic UES reconstruction. Results: Of 50 patients undergoing UES repair during the study period, 45 were included for analysis due to complete follow-up (34 [76%] robotic and 11 [24%] open repair). UES repair was performed in 50 renal units a median of 13 months (interquartile range 7-30) from index surgery, and most often involved the left renal unit (34/50; 68%). Compared with robotic, open cases were significantly more likely to have undergone open cystectomy (100% vs 68%, p = 0.04), have longer strictures (median 4 vs 1 cm, p < 0.001), require tissue substitution (27% vs 3%, p = 0.04), and have lengthier postoperative hospitalization (5 vs 2 days, p < 0.001). There was no significant difference in total operative time (410 vs 322 minutes) or 30d major complications (18% vs 21%). At a follow-up of 13 months, per patient reconstructive success was 100% (11/11) for open and 97% (33/34) for robotic, respectively. Conclusion: In select patients with short UES unlikely to require advanced reconstructive techniques, a robotic-assisted approach can be considered. Careful patient selection is associated with limited morbidity and high reconstructive success.
期刊介绍:
Journal of Endourology, JE Case Reports, and Videourology are the leading peer-reviewed journal, case reports publication, and innovative videojournal companion covering all aspects of minimally invasive urology research, applications, and clinical outcomes.
The leading journal of minimally invasive urology for over 30 years, Journal of Endourology is the essential publication for practicing surgeons who want to keep up with the latest surgical technologies in endoscopic, laparoscopic, robotic, and image-guided procedures as they apply to benign and malignant diseases of the genitourinary tract. This flagship journal includes the companion videojournal Videourology™ with every subscription. While Journal of Endourology remains focused on publishing rigorously peer reviewed articles, Videourology accepts original videos containing material that has not been reported elsewhere, except in the form of an abstract or a conference presentation.
Journal of Endourology coverage includes:
The latest laparoscopic, robotic, endoscopic, and image-guided techniques for treating both benign and malignant conditions
Pioneering research articles
Controversial cases in endourology
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Endourology survey section of endourology relevant manuscripts published in other journals.