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Chen S, Wang X, Li Z, Li X, Han G, Tao Z, Li Z, Zhang P, Zhu H, Yang K, Li X. Minimally invasive versus open ileal ureter with ileocystoplasty: comparative outcomes and 5-year experience. BMC Urol 2024; 24:118. [PMID: 38858691 PMCID: PMC11163719 DOI: 10.1186/s12894-024-01509-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Accepted: 06/04/2024] [Indexed: 06/12/2024] Open
Abstract
PURPOSE To present the experience of ileal ureter with ileocystoplasty (IUC), and compare the outcomes of IUC in minimally invasive procedures to open procedures. PATIENTS AND METHODS From December 2017 to April 2023, twenty patients underwent IUC in open or minimally invasive (including laparoscopic and robotic) procedures. The baseline characteristics, perioperative data and follow-up outcomes were collected. Success was defined as relief of clinical symptoms, stable postoperative serum creatine and absence of radiographic obstruction. The perioperative and follow-up outcomes of open procedures and minimally invasive procedures were compared. RESULTS The etiology included pelvic irradiation (14/20), urinary tuberculosis (3/20) and surgical injury (3/20). Bilateral ureter strictures were repaired in 15 cases. The surgeries conducted consisted of open procedures in 9 patients and minimally invasive procedures in 11 patients. Compared to open procedures, minimally invasive surgeries had less median estimated blood loss (EBL) (100 ml vs. 300 min, p = 0.010) and shorter postoperative hospitalization (27 d vs. 13 d, p = 0.004). Two patients in the open group experienced grade 3 complications (sigmoid fistula and acute cholecystitis in one patient, and pulmonary embolism in another patient). Over a median follow-up period of 20.1 months, the median bladder functional capacity was 300 ml, with a 100% success rate of IUC. CONCLUSION IUC is feasible in both open and minimally invasive procedures, with acceptable complications and a high success rate. Minimally invasive procedures can have less EBL and shorter postoperative hospitalization than open procedure. However, prospective studies with larger groups and longer follow-up are needed.
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Affiliation(s)
- Silu Chen
- Department of Urology, Institute of Urology, Peking University First Hospital, Peking University, National Urological Cancer Center, Xicheng District, Beijing, China
| | - Xiang Wang
- Department of Urology, Institute of Urology, Peking University First Hospital, Peking University, National Urological Cancer Center, Xicheng District, Beijing, China
| | - Zhihua Li
- Department of Urology, Institute of Urology, Peking University First Hospital, Peking University, National Urological Cancer Center, Xicheng District, Beijing, China
| | - Xinfei Li
- Department of Urology, Institute of Urology, Peking University First Hospital, Peking University, National Urological Cancer Center, Xicheng District, Beijing, China
| | - Guanpeng Han
- Department of Urology, Institute of Urology, Peking University First Hospital, Peking University, National Urological Cancer Center, Xicheng District, Beijing, China
| | - Zihao Tao
- Department of Urology, Institute of Urology, Peking University First Hospital, Peking University, National Urological Cancer Center, Xicheng District, Beijing, China
| | - Zhenyu Li
- Department of Urology, Institute of Urology, Peking University First Hospital, Peking University, National Urological Cancer Center, Xicheng District, Beijing, China
| | - Peng Zhang
- Department of Urology, Emergency General Hospital, Beijing, China
| | - Hongjian Zhu
- Department of Urology, Beijing Jiangong Hospital, Beijing, China
| | - Kunlin Yang
- Department of Urology, Institute of Urology, Peking University First Hospital, Peking University, National Urological Cancer Center, Xicheng District, Beijing, China.
| | - Xuesong Li
- Department of Urology, Institute of Urology, Peking University First Hospital, Peking University, National Urological Cancer Center, Xicheng District, Beijing, China.
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WALDNER MICHAEL, HERTLE LOTHAR, ROTH STEPHAN. A SURGICAL TECHNIQUE COMBINING CONTINENT CUTANEOUS URINARY DIVERSION AND COMPLETE ILEAL URETERAL REPLACEMENT. J Urol 1998. [DOI: 10.1016/s0022-5347(01)62410-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- MICHAEL WALDNER
- From the Department of Urology, University of Munster, Munster, and Department of Adult and Pediatric Urology, University of Witten, Herdecke Medical School, Klinikum Barmen, Wuppertal, Germany
| | - LOTHAR HERTLE
- From the Department of Urology, University of Munster, Munster, and Department of Adult and Pediatric Urology, University of Witten, Herdecke Medical School, Klinikum Barmen, Wuppertal, Germany
| | - STEPHAN ROTH
- From the Department of Urology, University of Munster, Munster, and Department of Adult and Pediatric Urology, University of Witten, Herdecke Medical School, Klinikum Barmen, Wuppertal, Germany
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