World journal of urology · 2026
Comparison of open, laparoscopic, and robot-assisted ileal ureter replacement for long ureteral strictures: a multi-institutional bidirectional cohort study.
СтатьяСравнительное исследованиеМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Wang Xiang, Yang Jiyu, Han Guanpeng, Li Zhihua, Zhang Yiming, Li Xinfei, Wang Bing, Zhang Peng, Huang Chen, Liu Jing, Zhu Hongjian, Yang Kunlin, Zhou Liqun, Zhang Kai, Li Xuesong
Аннотация
PURPOSE: To compare perioperative and follow-up outcomes of ileal ureter replacement (IUR) among open (O-IUR), laparoscopic (L-IUR) and robotic (R-IUR) approaches.
METHODS: We conducted a bidirectional cohort study of patients undergoing IUR for long ureteral strictures between September 2010 and April 2023 in our multi-institutional database. Clinical and follow-up outcomes were compared among the O-IUR, L-IUR and R-IUR groups. Clinical success was defined as symptom-free, stable renal function and no radiographic evidence of obstruction.
RESULTS: Among 106 patients (23 in O-IUR, 49 in L-IUR and 34 in R-IUR), the three groups had comparable demographic and baseline characteristics. The median operation time was significantly shorter in R-IUR compared to O-IUR (p = 0.029) and L-IUR (p < 0.001). The median estimated blood loss was statistically lower in R-IUR compared to O-IUR (p = 0.002) and L-IUR (p < 0.001). The median length of stay was statistically shorter in R-IUR compared to O-IUR (p < 0.001) and L-IUR (p < 0.001). The rate of postoperative Clavien-Dindo grade III complications was higher in O-IUR compared to L-IUR (p = 0.257) and R-IUR (p = 0.022).
CONCLUSION: Robotic ileal ureter replacement demonstrates clear perioperative advantages, consistent with the well-established superiority of robotic platforms in complex reconstructive procedures. However, differences in follow-up duration and potential time/experience bias should be acknowledged when interpreting complication rates.
METHODS: We conducted a bidirectional cohort study of patients undergoing IUR for long ureteral strictures between September 2010 and April 2023 in our multi-institutional database. Clinical and follow-up outcomes were compared among the O-IUR, L-IUR and R-IUR groups. Clinical success was defined as symptom-free, stable renal function and no radiographic evidence of obstruction.
RESULTS: Among 106 patients (23 in O-IUR, 49 in L-IUR and 34 in R-IUR), the three groups had comparable demographic and baseline characteristics. The median operation time was significantly shorter in R-IUR compared to O-IUR (p = 0.029) and L-IUR (p < 0.001). The median estimated blood loss was statistically lower in R-IUR compared to O-IUR (p = 0.002) and L-IUR (p < 0.001). The median length of stay was statistically shorter in R-IUR compared to O-IUR (p < 0.001) and L-IUR (p < 0.001). The rate of postoperative Clavien-Dindo grade III complications was higher in O-IUR compared to L-IUR (p = 0.257) and R-IUR (p = 0.022).
CONCLUSION: Robotic ileal ureter replacement demonstrates clear perioperative advantages, consistent with the well-established superiority of robotic platforms in complex reconstructive procedures. However, differences in follow-up duration and potential time/experience bias should be acknowledged when interpreting complication rates.