Department of Urology, Temple University, Philadelphia, PA, USA.
Investig Clin Urol. 2020 Feb;61(Suppl 1):S23-S32. doi: 10.4111/icu.2020.61.S1.S23. Epub 2019 Nov 21.
Distal ureteral reconstruction for benign pathologies such as stricture disease or iatrogenic injury has posed a challenge for urologist as endoscopic procedures have poor long-term outcomes, requiring definitive open reconstruction. Over the past decade, there has been an increasing shift towards robot-assisted laparoscopy (RAL) with multiple institutions reporting their outcomes. In this article, we reviewed the current literature on RAL distal ureteral reconstruction, focusing on benign pathologies only. We present peri-operative data and outcomes on the most common technique, ureteral reimplantation, as well as adjunct procedures such as psoas hitch and Boari flap. Additionally, we present alternative techniques reported in the literature with some technical considerations. Lastly, we describe the outcomes of the comparative studies between open, laparoscopy, and RAL. Although the body of literature in this field is limited, RAL reconstruction of the distal ureter appears to be safe, feasible, and with some advantages over the traditional open approach.
对于良性病变，如狭窄疾病或医源性损伤，远端输尿管重建一直是泌尿科医生面临的挑战，因为内镜手术的长期效果较差，需要进行确定性的开放重建。在过去的十年中，机器人辅助腹腔镜手术（RAL）的应用越来越多，多家机构报告了他们的结果。在本文中，我们回顾了关于 RAL 远端输尿管重建的现有文献，仅关注良性病变。我们介绍了最常见技术（输尿管再植入术）的围手术期数据和结果，以及辅助手术，如腰大肌悬带和 Boari 皮瓣。此外，我们还介绍了文献中报道的替代技术，并提出了一些技术考虑。最后，我们描述了开放手术、腹腔镜手术和 RAL 之间的比较研究结果。尽管该领域的文献数量有限，但 RAL 远端输尿管重建似乎是安全、可行的，并且相对于传统的开放方法具有一些优势。
