MP25-12 ROBOTIC BUCCAL GRAFT URETEROPLASTY WITHOUT URETERAL REST

摘要

You have accessJournal of UrologyCME1 May 2022MP25-12 ROBOTIC BUCCAL GRAFT URETEROPLASTY WITHOUT URETERAL REST Shellee Ogawa, Wesley Baas, Kushan Radadia, Alexander Parker, Kefu Du, Eric Kim, Robert Figenshau, and Gregory Murphy Shellee OgawaShellee Ogawa More articles by this author , Wesley BaasWesley Baas More articles by this author , Kushan RadadiaKushan Radadia More articles by this author , Alexander ParkerAlexander Parker More articles by this author , Kefu DuKefu Du More articles by this author , Eric KimEric Kim More articles by this author , Robert FigenshauRobert Figenshau More articles by this author , and Gregory MurphyGregory Murphy More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002568.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Robotic buccal graft ureteroplasty (RBGU) is a promising technique for ureteral reconstruction with growing evidence to support its use. Ureteral rest prior to ureteral reconstruction is often advocated by experts in the field. We describe our experience with RBGU at our institution without ureteral rest, focusing on perioperative management and outcomes to add to the growing body of literature for this approach. METHODS: We retrospectively reviewed patients who underwent RBGU at our institution from March 2018 to September 2021. Demographic information, operative details, and complications were recorded. All strictures were initially evaluated with retrograde pyelography and, when feasible, ureteroscopy to delineate stricture length and location. In all patients, a 6F ureteral stent was left in place preoperatively to improve the quality of the ureteral plate. After surgery, a stent was left in place for six weeks. Removal was initially done in clinic but is now done in the OR with retrograde pyelography. Patients were followed with renal ultrasound and, if necessary, renal scintigraphy. RESULTS: Seventeen patients were identified with a median age of 58 years (IQR 43-64). Median stricture length was 4.7 cm (range 3-7 cm). Median length of follow up was 13 months (IQR 5-20.5). All but one stent was removed at six weeks; the exception was due to a persistent leak on retrograde pyelography which resolved by ten weeks. Complications included one stricture recurrence/urinoma, one bowel obstruction which resolved with conservative measures, two UTIs and one readmission for pain control. Two patients had recurrent stone episodes requiring ureteroscopy. Overall success rate, defined as lack of stricture recurrence, was 93.3%. CONCLUSIONS: RBGU is a safe and effective procedure for management of complex ureteral strictures. Despite emerging evidence in support of ureteral rest, our series demonstrates low rates of recurrence without ureteral rest with moderate follow up. We believe preoperative stenting is not inferior to ureteral rest and is better tolerated by patients. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e432 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Shellee Ogawa More articles by this author Wesley Baas More articles by this author Kushan Radadia More articles by this author Alexander Parker More articles by this author Kefu Du More articles by this author Eric Kim More articles by this author Robert Figenshau More articles by this author Gregory Murphy More articles by this author Expand All Advertisement PDF downloadLoading ...