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. 2022 Mar:161:125-130.
doi: 10.1016/j.urology.2021.11.020. Epub 2022 Jan 7.

Robotic Repair of Ureteroenteric Stricture Following Radical Cystectomy: A Multi-Institutional Experience

Saum Ghodoussipour  1 , Nariman Ahmadi  2 , Alvin Goh  3 , Mehrdad Alemozaffar  4 , Reza Nabavizadeh  4 , Michele Gallucci  5 , Giuseppe Simone  5 , Gabriele Tuderti  5 , Inderbir Gill  2 , Mihir Desai  2 , Lee C Zhao  6 , Monish Aron  7
Affiliations

Robotic Repair of Ureteroenteric Stricture Following Radical Cystectomy: A Multi-Institutional Experience

Saum Ghodoussipour et al. Urology. 2022 Mar.

Abstract

Objective: To examine the safety, feasibility and durability of robotic reimplantation of ureteroenteric stricture after radical cystectomy.

Materials and methods: A retrospective multi-institutional review was performed for all patients undergoing robotic repair of ureteroenteric stricture from January 2010 to January 2019. Functional outcomes and complications were followed and data were analyzed with SPSS statistical software.

Results: A total of 46 patients and 58 renal units were identified, of which 15 had right sided, 19 left sided and 12 patients had bilateral strictures. Presentation of stricture was asymptomatic in 14 (30.4%) patients. Symptomatic presentations included infection in 22 (47.8%), worsening renal function in 11 (23.9%) and pain in 3 (6.5%) patients. Median time from cystectomy to diagnosis of stricture was 5 months (1-40). Median stricture length was 1.5 cm (range 0.5-10). All strictures were of benign etiology except for 4 (6.9%), which were due to malignancy. Overall, 49 (84.5%) ureters underwent primary re-implantation, while 9 (15.5%) required Boari-like advancement flaps prior to re-implantation. Median operative time was 190 min (range 45-540) with median estimated blood loss of 50 mL (range 25-2000) and median length of stay of 2 days (range 1-33, IQR 2-4). Seven (15.2%) patients experienced complications; 3 (6.5%) were low grade and 4 (8.7%) high grade. With median follow up of 18 months (range 1-51) the stricture recurrence rate was 8.6%.

Conclusion: Robotic reimplantation of ureteroenteric strictures following radical cystectomy is safe and feasible in experienced centers with high success rates.

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Conflict of interest statement

Conflict of Interest Mihir Desai: Consultant for PROCEPT and Auris. Monish Aron: Consultant for Intuitive Surgical.

Figures

Figure 1
Figure 1
Distal ureteric stricture following robotic radical cystectomy.
Figure 2
Figure 2
Development of advancement flap prior to ureteroenteric anastomosis.
See this image and copyright information in PMC

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