To characterize our single institutional experience with robotic and open uretero-enteric stricture (UES) repair. 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. 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% 68%, = 0.04), have longer strictures (median 4 1 cm, < 0.001), require tissue substitution (27% 3%, = 0.04), and have lengthier postoperative hospitalization (5 2 days, < 0.001). There was no significant difference in total operative time (410 322 minutes) or 30d major complications (18% 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. 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.
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http://dx.doi.org/10.1089/end.2024.0021 | DOI Listing |
Urologia
December 2024
Department of Urology, Gemelli isola Tiberina Hospital, Rome, Università Cattolica del Sacro Cuore, Rome, Italy.
Introduction And Objective: Radical Cystectomy (RC) is one of the most common and complex surgical procedures in urologic surgery, and benign ureteroenteric anastomosis strictures (UAS) are complications described in about 15% of patients undergoing RC with different urinary diversion (UD). The aim of this study is to evaluate and analyze risk factors related to the development of ureteral stenosis after RC.
Materials And Methods: All consecutive patients who underwent RC with ileal conduit from December 2019 to December 2022 were included.
Asian J Urol
July 2024
Department of Urology, Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets, Buffalo, New York, NY, USA.
Objective: We described the technique and outcomes of robot-assisted repair of uretero-enteric strictures (UES) following robot-assisted radical cystectomy (RARC) and urinary diversion.
Methods: Retrospective review of our RARC database from November 2005 to August 2023 at Roswell Park Comprehensive Cancer center was performed. Patients who developed UES and ultimately underwent robot-assisted uretero-enteric reimplantation (RUER) were identified.
Curr Urol Rep
November 2024
Department of Urology, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA, 19111, USA.
Purpose Of Review: The purpose of this review article is to provide a contemporary overview of benign uretero-enteric anastomotic stricture (UAS) management and outcomes.
Recent Findings: In this article, we will review the most recent studies investigating UAS and evaluate etiology, potential risk factors, presentation, diagnosis, and management options, along with personal insight gained from our experience with managing this challenging reconstructive complication. Benign UAS is a relatively common long-term complication of intestinal urinary diversion, affecting approximately 1 in 10 patients.
J Endourol
October 2024
Department of Urology, Mayo Clinic, Rochester, Minnesota, USA.
To characterize our single institutional experience with robotic and open uretero-enteric stricture (UES) repair. We queried our ureteral reconstructive database for UES repair between 01/2017 and 10/2023. Patients with <3 months follow-up were excluded.
View Article and Find Full Text PDFIntroduction: Use of indocyanine green (ICG) with near-infrared fluorescence (NIRF) has been demonstrated to be an effective tool for intraoperative assessment of bowel and ureteric vascularity. This study aimed to evaluate the impact of ICG on postsurgical outcomes such as anastomotic bowel leak and uretero-enteric stricture formation during robot-assisted cystectomy (RAC) and intracorporeal urinary diversion (ICUD).
Methods: We identified 238 patients who underwent RAC at the University of Louisville between September 2012 and August 2021.
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