V10-08 total laparoscopic ureteral substitution using appendix

TRODUCTION AND OBJECTIVES: Uretero-ileal anasto motic stricture is a well-known complication following radical cystectomy and urinary diversion with a rate of 8-12% in open and robotic series. Some strictures can be managed endoscopically but many require revision of the uretero-ileal anastomosis. W...

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Principais autores: Medeiros, Paulo, Britto, Cesar, Ferreira, Daniel, Júnior, Maurício, Alves, Rodolfo, Lima, Ronnie, Grossi, Thiago, Santos, Carla, Galvão, John Heyder
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Idioma:pt_BR
Publicado em: Journal of Urology
Assuntos:
postoperative
cystoscopy
obstruction
Endereço do item:https://repositorio.ufrn.br/handle/123456789/52737
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spelling ri-123456789-527372023-06-16T21:03:54Z V10-08 total laparoscopic ureteral substitution using appendix Medeiros, Paulo Britto, Cesar Ferreira, Daniel Júnior, Maurício Alves, Rodolfo Lima, Ronnie Grossi, Thiago Santos, Carla Galvão, John Heyder postoperative cystoscopy obstruction TRODUCTION AND OBJECTIVES: Uretero-ileal anasto motic stricture is a well-known complication following radical cystectomy and urinary diversion with a rate of 8-12% in open and robotic series. Some strictures can be managed endoscopically but many require revision of the uretero-ileal anastomosis. With increased utilization of robotic radical cystectomy we have started revising these strictures with a robotic approach as well. METHODS: From September 2014 - October 2016 we have performed 75 robotic radical cystectomies with 60 undergoing robotic intracorporeal ileal conduit urinary diversion. We found 6 patients that developed a uretero-ileal stricture. In the following video we highlight the technique for robotic revision of a right-sided uretero-ileal anasto motic stricuture in a patient following prior robotic radical cystectomy and intracorporeal ileal conduit urinary diversion. RESULTS: Our uretero-ileal anastomotic stricture rate following robotic radical cystectomy with intracorporeal conduit urinary diversion was 10%. Of these four were involving the left and two were involving the right ureter. Three patients were able to be managed with endo scopic dilation and three patients required revision of their uretero-ileal anastamotic stricture. All 3 patients were able to be managed with ro botic uretero-ileal anastomotic revision. Mean time to diagnosis of stricture was 182 days. For the patient in the video operative time was 62 minutes, EBL was 100cc, and length of stay was 1 day. The other two patients had other concomitant operations (parastomal hernia repair in one and takedown of pre-existing colon conduit in another) that significantly impacted operative time and length of stay and were not including in analysis of perioperative outcomes. CONCLUSIONS: Uretero-ileal anastomotic strictures following robotic radical cystectomy and intracorporeal conduit urinary diversion can safely and effectively be managed with a robotic approach. 2023-06-16T21:02:47Z 2023-06-16T21:02:47Z 2017-04-01 article BRITTO, Cesar Araújo et al. V10-08 Total laparoscopic ureteral substitution using appendix. Journal of Urology, S.l, v. 197, n. 4, p. e1200-e1201, 1 abr. 2017. DOI https://doi.org/10.1016/j.juro.2017.02.2793. Disponível em: https://www.auajournals.org/doi/10.1016/j.juro.2017.02.2793. Acesso em: 16 jun. 2023. https://repositorio.ufrn.br/handle/123456789/52737 10.1016/j.juro.2017.02.2793 pt_BR application/pdf Journal of Urology
institution Repositório Institucional
collection RI - UFRN
language pt_BR
topic postoperative
cystoscopy
obstruction
spellingShingle postoperative
cystoscopy
obstruction
Medeiros, Paulo
Britto, Cesar
Ferreira, Daniel
Júnior, Maurício
Alves, Rodolfo
Lima, Ronnie
Grossi, Thiago
Santos, Carla
Galvão, John Heyder
V10-08 total laparoscopic ureteral substitution using appendix
description TRODUCTION AND OBJECTIVES: Uretero-ileal anasto motic stricture is a well-known complication following radical cystectomy and urinary diversion with a rate of 8-12% in open and robotic series. Some strictures can be managed endoscopically but many require revision of the uretero-ileal anastomosis. With increased utilization of robotic radical cystectomy we have started revising these strictures with a robotic approach as well. METHODS: From September 2014 - October 2016 we have performed 75 robotic radical cystectomies with 60 undergoing robotic intracorporeal ileal conduit urinary diversion. We found 6 patients that developed a uretero-ileal stricture. In the following video we highlight the technique for robotic revision of a right-sided uretero-ileal anasto motic stricuture in a patient following prior robotic radical cystectomy and intracorporeal ileal conduit urinary diversion. RESULTS: Our uretero-ileal anastomotic stricture rate following robotic radical cystectomy with intracorporeal conduit urinary diversion was 10%. Of these four were involving the left and two were involving the right ureter. Three patients were able to be managed with endo scopic dilation and three patients required revision of their uretero-ileal anastamotic stricture. All 3 patients were able to be managed with ro botic uretero-ileal anastomotic revision. Mean time to diagnosis of stricture was 182 days. For the patient in the video operative time was 62 minutes, EBL was 100cc, and length of stay was 1 day. The other two patients had other concomitant operations (parastomal hernia repair in one and takedown of pre-existing colon conduit in another) that significantly impacted operative time and length of stay and were not including in analysis of perioperative outcomes. CONCLUSIONS: Uretero-ileal anastomotic strictures following robotic radical cystectomy and intracorporeal conduit urinary diversion can safely and effectively be managed with a robotic approach.
format article
author Medeiros, Paulo
Britto, Cesar
Ferreira, Daniel
Júnior, Maurício
Alves, Rodolfo
Lima, Ronnie
Grossi, Thiago
Santos, Carla
Galvão, John Heyder
author_facet Medeiros, Paulo
Britto, Cesar
Ferreira, Daniel
Júnior, Maurício
Alves, Rodolfo
Lima, Ronnie
Grossi, Thiago
Santos, Carla
Galvão, John Heyder
author_sort Medeiros, Paulo
title V10-08 total laparoscopic ureteral substitution using appendix
title_short V10-08 total laparoscopic ureteral substitution using appendix
title_full V10-08 total laparoscopic ureteral substitution using appendix
title_fullStr V10-08 total laparoscopic ureteral substitution using appendix
title_full_unstemmed V10-08 total laparoscopic ureteral substitution using appendix
title_sort v10-08 total laparoscopic ureteral substitution using appendix
publisher Journal of Urology
publishDate 2023
url https://repositorio.ufrn.br/handle/123456789/52737
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