Objective <p>Robotic ureteric reimplantation is increasingly utilised for benign distal and mid-ureteric pathology. However, medium-term outcomes remain underreported, particularly in UK practice, and optimal follow-up uncertain. We aimed to evaluate the safety and efficacy of robotic ureteric reimplantation for benign indications and inform optimal follow-up strategies.</p> Methods <p>Retrospective review of 67 patients undergoing robotic ureteric reimplantation at a tertiary UK centre between 2016 and 2023. Primary outcomes included postoperative obstruction and need for long-term urinary drainage. Secondary outcomes were post-operative complications, change in renal function, and hospital stay. Descriptive statistics and paired t-tests were used.</p> Key findings and limitations <p>Sixty-seven patients (40 females, 27 males) underwent robotic ureteric reimplantation for benign disease. Causes were urological (54%) and gynaecological (45%), mostly operative injuries. Techniques included Lich-Gregoir (<i>n</i> = 56), psoas hitch (<i>n</i> = 5), and Boari flap (<i>n</i> = 6). One case was converted to open surgery at the start of the learning curve. Median hospital stay was 2 days. Mean follow-up was 709 days. Four patients (6%) showed radiological obstruction; three required further intervention. Renal function remained stable (mean creatinine change − 2 ± 12.5 mmol/L, <i>p</i> = 0.07). Eleven patients experienced Clavien-Dindo grade II complications. One patient with prior radiotherapy required cystectomy for a poorly compliant bladder.</p> Conclusions and clinical implications <p>Robotic ureteric reimplantation for benign disease is safe and effective. Most complications occur within the first year, and long-term monitoring is recommended in select cases including radiation cases.</p>

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Robotic ureteric reimplantation for benign disease in a tertiary UK centre: safe and effective

  • Samuel Stephen Folkard,
  • Martina Spazzapan,
  • Mohamed Gad,
  • Harry Sharples,
  • Lucy Chapman,
  • Calum Clark,
  • Shamim Khan,
  • Raj Nair,
  • Sachin Malde,
  • Arun Sahai

摘要

Objective

Robotic ureteric reimplantation is increasingly utilised for benign distal and mid-ureteric pathology. However, medium-term outcomes remain underreported, particularly in UK practice, and optimal follow-up uncertain. We aimed to evaluate the safety and efficacy of robotic ureteric reimplantation for benign indications and inform optimal follow-up strategies.

Methods

Retrospective review of 67 patients undergoing robotic ureteric reimplantation at a tertiary UK centre between 2016 and 2023. Primary outcomes included postoperative obstruction and need for long-term urinary drainage. Secondary outcomes were post-operative complications, change in renal function, and hospital stay. Descriptive statistics and paired t-tests were used.

Key findings and limitations

Sixty-seven patients (40 females, 27 males) underwent robotic ureteric reimplantation for benign disease. Causes were urological (54%) and gynaecological (45%), mostly operative injuries. Techniques included Lich-Gregoir (n = 56), psoas hitch (n = 5), and Boari flap (n = 6). One case was converted to open surgery at the start of the learning curve. Median hospital stay was 2 days. Mean follow-up was 709 days. Four patients (6%) showed radiological obstruction; three required further intervention. Renal function remained stable (mean creatinine change − 2 ± 12.5 mmol/L, p = 0.07). Eleven patients experienced Clavien-Dindo grade II complications. One patient with prior radiotherapy required cystectomy for a poorly compliant bladder.

Conclusions and clinical implications

Robotic ureteric reimplantation for benign disease is safe and effective. Most complications occur within the first year, and long-term monitoring is recommended in select cases including radiation cases.