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A Multi-Institutional Experience Utilizing Boari Flap in Robotic Urinary Reconstruction

医学 外科 围手术期 前瞻性队列研究 泌尿系统 病因学 心理干预 内科学 精神科
作者
Tanner Corse,Linda Dayan,Nathan Cheng,Allison C. Brown,Naveen M. Krishnan,Kirtishri Mishra,Ruth Sanchez De La Rosa,Mutahar Ahmed,Gregory Lovallo,Daniel Eun,Lee C. Zhao,Michael Stifelman
出处
期刊:Journal of Endourology [Mary Ann Liebert, Inc.]
被引量:9
标识
DOI:10.1089/end.2022.0618
摘要

Objectives: There is presently scarce literature describing the outcomes of patients undergoing robotic ureteral reconstruction (RUR) using the Boari flap (BF) technique. Herein, we report our prospective, multi-institutional experience using BF in patients undergoing robotic urinary reconstruction. Patients and Methods: We reviewed our prospective, multicenter database for all patients undergoing RUR between September 2013 and September 2021 in which a BF was utilized. Preoperative, perioperative, and follow-up data were collected and analyzed. Major complications were defined as a Clavien–Dindo classification grade >2. Surgical failure was defined as recurrent symptoms, obstruction on imaging, or the need for additional surgical interventions. Results: We identified 50 patients who underwent RUR using a BF. Four (8%) underwent the Single Port approach. Twenty-four patients (48%) were active or former tobacco users. Thirty-four patients (68%) had previously undergone abdominal surgery, 17 (34%) had prior ureteral stricture interventions, and 9 (18%) had prior abdominopelvic radiation. The most common stricture etiology was malignancy (34.4%). The median follow-up was 15.0 months with a 90% (45/50) success rate. The five documented cases of failure occurred at a median of 1.8 months following the procedure. Conclusion: In the largest prospective, multi-institutional study of patients undergoing RUR with BF in the literature to date, we demonstrate a low rate of complications and a high rate of surgical success in three tertiary academic medical centers. All observed failures occurred within 2 months of surgical intervention.
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