Management for Ureteral Stenosis: A Comparison of Robot-Assisted Laparoscopic Ureteroureterostomy and Conventional Laparoscopic Ureteroureterostomy

J Laparoendosc Adv Surg Tech A. 2019 Sep;29(9):1111-1115. doi: 10.1089/lap.2019.0357. Epub 2019 Jul 17.

Abstract

Background: To describe and analyze our experience of robotic-assisted laparoscopic ureteroureterostomy (RALU) and conventional LU for the repair of ureteral stenosis and compare the differences of safety and efficacy between RALU and LU. Materials and Methods: Patients who underwent RALU or LU for ureteral stenosis were retrospectively analyzed. Baseline characteristics, details of stenosis, surgery and some laboratory tests, and follow-up data were collected and analyzed. Results: Among 126 patients presented with ureteral stenosis, 65 patients underwent RALU and 61 patients underwent LU. All operations were completed successfully without conversion to open surgery. Both groups were comparable in baseline characteristics and details of stenosis. The mean operative time, suturing time, and hospitalization time of patients in RALU group were significantly less than those in LU group. The mean operative time of the RALU group was 126.34 minutes, whereas the mean operative time of the LU group was 176.57 minutes (P < .001). The average suturing time of RALU and LU was 26.88 and 70.43 minutes, respectively (P < .001). The mean hospitalization time of RALU and LU was 4.01 and 5.02, respectively (P < .001). RALU presented a lower degree of leukocytes rise than LU (P < .001). The mean follow-up time was 29.52 months. Conclusions: RALU and LU both are safe and feasible for ureteral stenosis with a low incidence of complications. Compared with LU, RALU may be a better choice with shorter operative time, suturing time, postoperative hospitalization time, and slighter inflammation. Further clinical studies of high quality are needed to confirm the priority of RALU.

Keywords: anastomosis; end-to-end; laparoscopic; robotic; ureteral stenosis; ureteroureterostomy.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Anastomosis, Surgical / methods
  • Female
  • Humans
  • Laparoscopy / methods*
  • Male
  • Middle Aged
  • Operative Time
  • Postoperative Period
  • Retrospective Studies
  • Robotics / methods*
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Ureter / surgery*
  • Ureteral Obstruction / diagnosis
  • Ureteral Obstruction / surgery*
  • Ureterostomy / methods*
  • Young Adult