Loading...
Perioperative and Functional Outcomes of Robot-assisted Ureteroenteric Reimplantation: A Multicenter Study of Seven Referral Institutions
Carrion, Albert Hussein, Ahmed Aly Hosseini, Abolfazl Gaya, Josep Maria Abaza, Ronney Bonet, Xavier Iqbal, Umar Lee, Randall A. Lee, Ziho
Carrion, Albert
Hussein, Ahmed Aly
Hosseini, Abolfazl
Gaya, Josep Maria
Abaza, Ronney
Bonet, Xavier
Iqbal, Umar
Lee, Randall A.
Lee, Ziho
Citations
Altmetric:
Genre
Journal article
Date
2022-01-03
Advisor
Committee member
Group
Department
Urology
Permanent link to this record
Collections
Research Projects
Organizational Units
Journal Issue
DOI
http://dx.doi.org/10.1016/j.euros.2021.11.005
Abstract
Background: Open revision of ureteroenteric strictures (UESs) is associated with considerable morbidity. There is a lack of data evaluating the feasibility of robotic revisions. Objective: To analyze the perioperative and functional outcomes of robot-assisted ureteroenteric reimplantation (RUER) for the management of UESs after radical cystectomy (RC). Design, setting, and participants: A retrospective multicenter study of 61 patients, who underwent 63 RUERs at seven high-volume institutions between 2009 and 2020 for benign UESs after RC, was conducted. Outcome measurements and statistical analysis: Data were reviewed for demographics, stricture characteristics, and perioperative outcomes. Variables associated with being stricture free after an RUER were evaluated using a multivariate Cox regression analysis. Results and limitations: Among 63 RUERs, 22 were right sided (35%), 34 left sided (54%), and seven bilateral (11%). Twenty-seven (44%) had prior abdominal/pelvic surgery and five (8%) radiotherapy (RT). Thirty-two patients had American Society of Anesthesiologists (ASA) scores I–II (52%) and 29 ASA III (48%). Forty-two (68%) RUERs were in ileal conduits, 18 (29%) in neobladders, and two (3%) in Indiana pouch. The median time to diagnosis of a UES from cystectomy was 5 (3–11) mo. Of the UESs, 28 (44%) failed an endourological attempt (balloon dilatation/endoureterotomy). The median RUER operative time was 195 (175–269) min. No intraoperative complications or conversions to open approach were reported. Twenty-three (37%) patients had postoperative complications (20 [32%] were minor and three [5%] major). The median length of hospital stay was 3 (1–6) d and readmissions were 5%. After a median follow-up of 19 (8–43) mo, 84% of cases were stricture free. Lack of prior RT was the only variable associated with better stricture-free survival after RUER (hazard ratio 6.8, 95% confidence interval 1.10–42.00, p = 0.037). The study limitations include its retrospective nature and the small number of patients. Conclusions: RUER is a feasible procedure for the management of UESs. Prospective and larger studies are warranted to prove the safety and efficacy of this technique. Patient summary: In this study, we investigate the feasibility of a novel minimally invasive technique for the management of ureteroenteric strictures. We conclude that robotic reimplantation is a feasible and effective procedure.
Description
Citation
Albert Carrion, Ahmed Aly Hussein, Daniel Eun, Abolfazl Hosseini, Josep Maria Gaya, Ronney Abaza, Xavier Bonet, Umar Iqbal, Randall A. Lee, Ziho Lee, Matthew Lee, Carles Raventos, Oriol Moreno, Joan Palou, Alberto Breda, Fernando Lozano, Francesc Vigués, Enrique Trilla, Khurshid A. Guru, Perioperative and Functional Outcomes of Robot-assisted Ureteroenteric Reimplantation: A Multicenter Study of Seven Referral Institutions, European Urology Open Science, Volume 35, 2022, Pages 47-53, ISSN 2666-1683, https://doi.org/10.1016/j.euros.2021.11.005.
Citation to related work
Elsevier
Has part
European Urology Open Science, Vol. 35
ADA compliance
For Americans with Disabilities Act (ADA) accommodation, including help with reading this content, please contact scholarshare@temple.edu