Comparative Analysis of Efficacy and Complications of Robot-Assisted Open Dismembered Ureteral Reimplantation for Primary Obstructive Megaureter.

Dismembered ureteral reimplant (DUR) is done to treat primary obstructive megaureter (POM). To describe and compare outcomes between open dismembered ureteral reimplant (ODUR) robot-assisted laparoscopic dismembered ureteral reimplant (RALDUR). An IRB-approved registry was used to retrospectively identify all patients who underwent DUR for POM between 2015 and 2022. Demographics, preoperative, perioperative, and long-term outcomes were analyzed. -Values were two sided, and a < 0.05 was considered significant. Our cohort consisted of 50 patients: 14 (28%) underwent ODUR, and 36 (72%) underwent RALDUR. Preoperatively, no differences were noted between RALDUR and ODUR in terms of antenatal hydronephrosis ( = 1.00), febrile urinary tract infection ( = 0.09), and reflux grade on preoperative voiding cystourethrogram ( = 0.53). Ipsilateral kidney function was 37% in the RALDUR group compared with 32% in the ODUR, with no difference between them ( = 0.74). RALDUR was associated with a longer procedure time (278 minutes 191 minutes, = 0.001) and a similar rate of ureteral tapering (61% 86%, = 0.18). Both cohorts had similar length of stay ( = 0.33) and IV morphine use ( = 0.84). Postoperatively, only three (6%) had Clavien Dindo grade 3b complications-one in the ODUR group who required percutaneous nephrostomy tube (PCN) placement by IR and two in the RALDUR group, one had a port-site hernia s/p repair, and one had a retained JP drain requiring removal. During follow-up, 34 (94.4%) patients in the RALDUR group had stable/improved hydronephrosis in their most recent ultrasound compared with 14 (100%) in the ODUR. Neither group underwent a reintervention procedure. RALDUR is shown to have comparable success and efficacy to ODUR. A longer procedure time is reported in RALDUR.