医学
肾盂成形术
外科
机械人手术
回顾性队列研究
背景(考古学)
普通外科
人口
并发症
肾积水
泌尿系统
内科学
生物
环境卫生
古生物学
作者
Nicolò Maria Buffi,Giovanni Lughezzani,Rodolfo Hurle,Massimo Lazzeri,Gianluigi Taverna,Giorgio Bozzini,Riccardo Bertolo,Enrico Checcucci,Francesco Porpiglia,Nicola Fossati,Giorgio Gandaglia,Alessandro Larcher,Nazareno Suardi,Francesco Montorsi,Giuliana Lista,Giorgio Guazzoni,Alexandre Mottrie
标识
DOI:10.1016/j.eururo.2016.07.022
摘要
Minimally invasive treatment of benign ureteral strictures is still challenging because of its technical complexity. In this context, robot-assisted surgery may overcome the limits of the laparoscopic approach. To evaluate outcomes for robotic ureteral repair in a multi-institutional cohort of patients treated for ureteropelvic junction obstruction and ureteral stricture (US) at four tertiary referral centres. This retrospective study reports data for 183 patients treated with standard robot-assisted pyeloplasty (PYP) and robotic uretero-ureterostomy (UUY) at four high-volume centres from January 2006 to September 2014. Robotic PYP and robot-assisted UUY were performed according to previously reported surgical techniques. Preoperative, intraoperative, and postoperative variables and outcomes were assessed. A descriptive statistical analysis was performed. No robot-assisted UUY cases required surgical conversion, while 2.8% of PYP cases were not completed robotically. The median operative time was 120 and 150 min for robot-assisted PYP and robot-assisted UUY, respectively. No intraoperative complications were reported. The overall complication rate for all procedures was 11% (n = 20) and complications were mostly of low grade. The high-grade complication rate was 2.2% (n = 4). At median follow-up of 24 mo, the overall success rate was >90% for both procedures. The study limitations include its retrospective nature and the heterogeneity of the study population. Robotic surgery for benign US is safe and effective, with limited risk of high-grade complications and good intermediate-term results. In this study we review the use of robotic surgery at four different tertiary care centres in the treatment of patients affected by benign ureteral strictures. Our results demonstrate that robotic surgery is a safe alternative to the standard open approach in the treatment of ureteral strictures.
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