Robot-assisted ureteral reconstruction for managing kidney transplant patients with ureteric complications
"Purpose: To evaluate the feasibility of robot-assisted ureteral reconstruction as a minimally invasive alternative to open surgery for managing ureteric complications in transplanted kidneys. Materials and Methods: From January 2020 to December 2023, robot-assisted ureteral reconstruction was...
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| Format: | Article |
| Language: | English |
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Korean Urological Association
2025-01-01
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| Series: | Investigative and Clinical Urology |
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| Online Access: | https://www.icurology.org/pdf/10.4111/icu.20240308 |
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| author | Dongho Shin San Kang Seung Ah Rhew Chang Eil Yoon Hyong Woo Moon Yong Hyun Park Hyuk Jin Cho |
| author_facet | Dongho Shin San Kang Seung Ah Rhew Chang Eil Yoon Hyong Woo Moon Yong Hyun Park Hyuk Jin Cho |
| author_sort | Dongho Shin |
| collection | DOAJ |
| description | "Purpose: To evaluate the feasibility of robot-assisted ureteral reconstruction as a minimally invasive alternative to open surgery for managing ureteric complications in transplanted kidneys.
Materials and Methods: From January 2020 to December 2023, robot-assisted ureteral reconstruction was performed on fifteen kidney transplant patients with vesicoureteral reflux (VUR) or ureteral stricture who had previously failed endoscopic treatments.
Results: Twelve females and three males, with a mean age of 48.6±6.6 years, were included in the study. Nine patients (60.0%) underwent surgery due to VUR (grade III or higher) of the transplanted kidney, and six patients (40.0%) had transplanted ureteral strictures. Postoperative voiding cystourethrogram (VCUG) was performed at 3.2±1.6 months. Seven patients (77.8%) became VUR-free, while two patients (22.2%) had VUR regression from grade IV to I. All six patients who underwent reconstruction due to anastomosis site stricture became stenosis-free without the need for an indwelling ureteral catheter. In cases where the ureter was too short for reimplantation, a Boari flap or end-to-end anastomosis with the native ureter was performed. The mean hospital stay was 5.9±4.5 days. The urethral catheter was removed after 15.1±5.4 days, and the ureteral catheter was removed after 4.9±1.5 weeks. The mean follow-up period was 23.9±6.8 months, with no additional interventions required after surgery. No complications above Clavien-Dindo grade I were recorded.
Conclusions: Robotic ureteral reconstruction is technically feasible and offers an effective, minimally invasive treatment for ureteric complications in kidney transplant patients, serving as an alternative to open surgery."
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| format | Article |
| id | doaj-art-77ea87e6024246648da565d1773c1eb3 |
| institution | Kabale University |
| issn | 2466-0493 2466-054X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Korean Urological Association |
| record_format | Article |
| series | Investigative and Clinical Urology |
| spelling | doaj-art-77ea87e6024246648da565d1773c1eb32025-01-09T09:08:02ZengKorean Urological AssociationInvestigative and Clinical Urology2466-04932466-054X2025-01-01661182610.4111/icu.20240308Robot-assisted ureteral reconstruction for managing kidney transplant patients with ureteric complicationsDongho Shin0https://orcid.org/0000-0001-8496-8825 San Kang1https://orcid.org/0009-0009-9417-3685 Seung Ah Rhew2https://orcid.org/0009-0002-6903-034XChang Eil Yoon3https://orcid.org/0000-0002-6089-1728Hyong Woo Moon4https://orcid.org/0000-0002-9352-3411 Yong Hyun Park5https://orcid.org/0000-0003-4860-6127Hyuk Jin Cho6https://orcid.org/0000-0003-2599-2950Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea.Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea.Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea.Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea.Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea.Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea.Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea."Purpose: To evaluate the feasibility of robot-assisted ureteral reconstruction as a minimally invasive alternative to open surgery for managing ureteric complications in transplanted kidneys. Materials and Methods: From January 2020 to December 2023, robot-assisted ureteral reconstruction was performed on fifteen kidney transplant patients with vesicoureteral reflux (VUR) or ureteral stricture who had previously failed endoscopic treatments. Results: Twelve females and three males, with a mean age of 48.6±6.6 years, were included in the study. Nine patients (60.0%) underwent surgery due to VUR (grade III or higher) of the transplanted kidney, and six patients (40.0%) had transplanted ureteral strictures. Postoperative voiding cystourethrogram (VCUG) was performed at 3.2±1.6 months. Seven patients (77.8%) became VUR-free, while two patients (22.2%) had VUR regression from grade IV to I. All six patients who underwent reconstruction due to anastomosis site stricture became stenosis-free without the need for an indwelling ureteral catheter. In cases where the ureter was too short for reimplantation, a Boari flap or end-to-end anastomosis with the native ureter was performed. The mean hospital stay was 5.9±4.5 days. The urethral catheter was removed after 15.1±5.4 days, and the ureteral catheter was removed after 4.9±1.5 weeks. The mean follow-up period was 23.9±6.8 months, with no additional interventions required after surgery. No complications above Clavien-Dindo grade I were recorded. Conclusions: Robotic ureteral reconstruction is technically feasible and offers an effective, minimally invasive treatment for ureteric complications in kidney transplant patients, serving as an alternative to open surgery." https://www.icurology.org/pdf/10.4111/icu.20240308kidney transplantationobstructionureteralrobot-assisted surgeryvesicoureteral reflux |
| spellingShingle | Dongho Shin San Kang Seung Ah Rhew Chang Eil Yoon Hyong Woo Moon Yong Hyun Park Hyuk Jin Cho Robot-assisted ureteral reconstruction for managing kidney transplant patients with ureteric complications Investigative and Clinical Urology kidney transplantation obstruction ureteral robot-assisted surgery vesicoureteral reflux |
| title | Robot-assisted ureteral reconstruction for managing kidney transplant patients with ureteric complications |
| title_full | Robot-assisted ureteral reconstruction for managing kidney transplant patients with ureteric complications |
| title_fullStr | Robot-assisted ureteral reconstruction for managing kidney transplant patients with ureteric complications |
| title_full_unstemmed | Robot-assisted ureteral reconstruction for managing kidney transplant patients with ureteric complications |
| title_short | Robot-assisted ureteral reconstruction for managing kidney transplant patients with ureteric complications |
| title_sort | robot assisted ureteral reconstruction for managing kidney transplant patients with ureteric complications |
| topic | kidney transplantation obstruction ureteral robot-assisted surgery vesicoureteral reflux |
| url | https://www.icurology.org/pdf/10.4111/icu.20240308 |
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