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. 2023 Oct 12;23(1):160.
doi: 10.1186/s12894-023-01313-7.

Robotic ureteral reconstruction for benign ureteral strictures: a systematic review of surgical techniques, complications and outcomes : Robotic Ureteral Reconstruction for Ureteral Strictures

Kunlin Yang  1   2   3 , Karl H Pang  4   5   6 , Shubo Fan  1   2   3 , Xinfei Li  1   2   3 , Nadir I Osman  7 , Christopher R Chapple  7 , Liqun Zhou  1   2   3 , Xuesong Li  8   9   10
Affiliations

Robotic ureteral reconstruction for benign ureteral strictures: a systematic review of surgical techniques, complications and outcomes : Robotic Ureteral Reconstruction for Ureteral Strictures

Kunlin Yang et al. BMC Urol. .

Abstract

Introduction: Robotic ureteral reconstruction (RUR) has been widely used to treat ureteral diseases. To summarize the surgical techniques, complications, and outcomes following RUR, as well as to compare data on RUR with open and laparoscopic ureteral reconstruction.

Methods: Our systematic review was registered on the PROSPERO (CRD42022309364) database. The PubMed, Cochrane and Embase databases were searched for publications in English on 06-Feb-2022. Randomised-controlled trials (RCTs) or non-randomised cohort studies with sample size ≥ 10 cases were included.

Results: A total of 23 studies were included involving 996 patients and 1004 ureters from 13 non-comparative, and 10 retrospective comparative studies. No RCT study of RUR was reported. The success rate was reported ≥ 90% in 15 studies. Four studies reported 85-90% success rate. Meta-analyses for comparative studies showed that RUR had significantly lower estimated blood loss (EBL) (P = 0.006) and shorter length of stay (LOS) (P < 0.001) than the open approach. RUR had shorter operative time than laparoscopic surgery (P < 0.001).

Conclusions: RUR is associated with lower EBL and shorter LOS than the open approach, and shorter operative time than the laparoscopic approach for the treatment of benign ureteral strictures. However, further studies and more evidence are needed to determine whether RUR is more superior.

Keywords: Laparoscopic; Minimally invasive; Reconstruction; Robotic; Ureteral stricture.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram of the study selection process
Fig. 2
Fig. 2
Aetiology associated with ureteral strictures
Fig. 3
Fig. 3
Forest plots of comparison between robotic and open ureteral reconstruction for estimated blood loss (A), operative time (B), length of stay (C), follow-up time (D) and success rate (E); SD, standard deviation; CI, confidence interval
Fig. 4
Fig. 4
Forest plots of comparison between robotic and laparoscopic ureteral reconstruction for estimated blood loss (A), operative time (B), length of stay (C), follow-up time (D) and success rate (E); SD, standard deviation; CI, confidence interval
Fig. 5
Fig. 5
The surgical categories for ureteral reconstruction
See this image and copyright information in PMC

References

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