机器人辅助阑尾输尿管成形术的多机构经验

A Multi-Institutional Experience With Robotic Appendiceal Ureteroplasty.

作者信息

Jun Min Suk, Stair Sabrina, Xu Alex, Lee Ziho, Asghar Aeen M, Strauss David, Stifelman Michael D, Eun Daniel, Zhao Lee C

机构信息

Department of Urology, New York University Grossman School of Medicine at New York University Langone Medical Center, New York, NY.

Department of Urology, Lewis Katz School of Medicine at Temple University, Philadelphia, PA.

出版信息

Urology. 2020 Nov;145:287-291. doi: 10.1016/j.urology.2020.06.062. Epub 2020 Jul 15.

DOI:10.1016/j.urology.2020.06.062

PMID:32681918

Abstract

OBJECTIVE

To report a multi-institutional experience with robotic appendiceal ureteroplasty.

METHODS

This is a retrospective review of 13 patients undergoing right appendiceal flap ureteroplasty at 2 institutions between April 2016 and October 2019. The primary endpoint was surgical success defined by the absence of flank pain and radiographic evidence of ureteral patency.

RESULTS

Eight of 13 (62%) underwent appendiceal onlay while 5/13 (38%) underwent appendiceal interposition. Mean length of stricture was 6.5 cm (range 1.5-15 cm) affecting anywhere along the right ureter. Mean operative time was 337 minutes (range 206-583), mean estimated blood loss was 116 mL (range 50-600), and median length of stay was 2.5 days (range 1-9). Balloon dilation was required in 1/12 (8%). One patient died on postoperative day 0 due to a sudden cardiovascular event. Otherwise, there were no complications (Clavien-Dindo > 2) within 30 days from surgery. At a mean follow up of 14.6 months, 11/12 (92%) were successful.

CONCLUSION

Robotic appendiceal ureteroplasty for right ureteral strictures is a versatile technique with high success rates across institutions.

摘要

目的

报告多机构开展机器人辅助阑尾输尿管成形术的经验。

方法

对2016年4月至2019年10月期间在两家机构接受右阑尾瓣输尿管成形术的13例患者进行回顾性研究。主要终点为手术成功，定义为无胁腹疼痛且输尿管通畅的影像学证据。

结果

13例患者中，8例（62%）接受阑尾覆盖术，5例（38%）接受阑尾置入术。狭窄平均长度为6.5厘米（范围1.5 - 15厘米），累及右侧输尿管的任何部位。平均手术时间为337分钟（范围206 - 583分钟），平均估计失血量为116毫升（范围50 - 600毫升），中位住院时间为2.5天（范围1 - 9天）。12例患者中有1例（8%）需要球囊扩张。1例患者术后第0天因突发心血管事件死亡。除此之外，术后30天内无并发症（Clavien-Dindo分级>2级）。平均随访14.6个月时，12例患者中有11例（92%）手术成功。