Citation
Lee M, Zhao K, Chao B, Lee Z, Munver R, Ahmed M, Stifelman MD, Zhao LC, Eun DD; Collaborative of Reconstructive Robotic Ureteral Surgery (CORRUS). Preoperative Factors for Success of Robotic Ureteral Reconstruction for Distal Ureteral Strictures. J Endourol. 2024 Dec;38(12):1359-1363. doi: 10.1089/end.2024.0595. Epub 2024 Oct 21. PMID: 39432479.
Abstract
Introduction: To investigate preoperative predictors of surgical success for patients undergoing robotic ureteral reconstruction (RUR) for management of distal ureteral strictures. Methods: We retrospectively reviewed our multi-institutional Collaborative of Reconstructive Robotic Ureteral Surgery database to identify all consecutive patients undergoing RUR for surgical repair of distal ureteral strictures between 04/2012 and 12/2022. Procedures included refluxing reimplant (58.5%), side to side reimplant (18.0%), ureteroureterostomy (12.7%), non-refluxing reimplant (6.3%), buccal mucosa ureteroplasty (2.8%), and appendiceal bypass ureteroplasty (1.7%). Patients were grouped according to whether they were surgically successful. Preoperative variables between both groups were compared using chi-square tests. All variables with associations of p < 0.2 underwent a binary logistic regression analysis to determine predictive variables of success for RUR (p ≤ 0.05 considered statistically significant). Results: Overall, 284 patients met inclusion criteria. Univariate analysis showed obesity (p = 0.03), smoking history (p = 0.10), abdominopelvic radiation history (p = 0.14), immunocompromised state (p = 0.12), and ureteral rest (p = 0.01) were notable preoperative factors (p < 0.2). Binary logistic regression analysis further revealed the odds of surgical success in patients with obesity was 0.32 times (CI: 0.12-0.83, p = 0.02) the odds of success for patients without obesity. The odds of surgical success in patients who underwent preoperative ureteral rest was 4.2 times (CI: 1.51-11.77, p < 0.01) the odds of success for patients who did not undergo preoperative ureteral rest. Conclusion: Preoperative factors including obesity and ureteral rest may affect surgical success of RUR for management of distal ureteral strictures.
Key Points
- Published in Journal of endourology in 2024.
- Indexed in PubMed as PMID 39432479.
- 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.