Citation
Corse TD, Dayan L, Cheng N, Brown A, Krishnan N, Mishra K, Sanchez De La Rosa R, Ahmed M, Lovallo G, Eun D, Zhao L, Stifelman M. A Multi-Institutional Experience Utilizing Boari Flap in Robotic Urinary Reconstruction. J Endourol. 2023 Apr 26. doi: 10.1089/end.2022.0618. Epub ahead of print. PMID: 37128188.
Abstract
Objectives: There is presently scarce literature describing the outcomes of patients undergoing robotic ureteral reconstruction (RUR) using the Boari flap (BF) technique. Herein, we report our prospective, multi-institutional experience using BF in patients undergoing robotic urinary reconstruction. Patients and Methods: We reviewed our prospective, multicenter database for all patients undergoing RUR between September 2013 and September 2021 in which a BF was utilized. Preoperative, perioperative, and follow-up data were collected and analyzed. Major complications were defined as a Clavien-Dindo classification grade >2. Surgical failure was defined as recurrent symptoms, obstruction on imaging, or the need for additional surgical interventions. Results: We identified 50 patients who underwent RUR using a BF. Four (8%) underwent the Single Port approach. Twenty-four patients (48%) were active or former tobacco users. Thirty-four patients (68%) had previously undergone abdominal surgery, 17 (34%) had prior ureteral stricture interventions, and 9 (18%) had prior abdominopelvic radiation. The most common stricture etiology was malignancy (34.4%). The median follow-up was 15.0 months with a 90% (45/50) success rate. The five documented cases of failure occurred at a median of 1.8 months following the procedure. Conclusion: In the largest prospective, multi-institutional study of patients undergoing RUR with BF in the literature to date, we demonstrate a low rate of complications and a high rate of surgical success in three tertiary academic medical centers. All observed failures occurred within 2 months of surgical intervention.
Key Points
- Published in Journal of endourology in 2023.
- Indexed in PubMed as PMID 37128188.
- Mapped to Ureteral Reconstruction, Urethral Stricture & Urethroplasty, Robotic & Single-Port.
- Abstract available from PubMed and rendered as static text on this page.
Clinical Relevance
This work sits within Dr. Zhao's upper urinary tract reconstruction bibliography, including robotic ureteral repair, buccal mucosa graft ureteroplasty, reimplantation, pyeloplasty failure, and complex salvage reconstruction.