Robotic ileal ureter replacement vs kidney autotransplantation for long ureteric strictures

Objective To compare functional and surgical outcomes of robot-assisted ileal ureter replacement (RAIUR) vs robot-assisted kidney autotransplantation (RAKAT). Patients and Methods This was a retrospective analysis of patients who underwent RAIUR or RAKAT for long ureteric strictures at eight Europea...

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Autores: Afferi, L, Gallioli, A, Territo, A, Cannoletta, D, Mestdagh, K, Vangeneugden, J, Van Praet, C, Desender, L, Mercier, J, Prudhomme, T, Salamone, V, Fontana, G, Albisinni, S, Osswald, R, John, H, Etcheverry, B, Vigués, F, Doumerc, N, Minervini, A, Palou, J, Decaestecker, K, Breda, A
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:España
Institución:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
Repositorio:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
OAI Identifier:oai:iibsantpau.fundanetsuite.com:p19343
Acceso en línea:https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=19343
Access Level:acceso abierto
Palabra clave:ileal ureter replacement
kidney autotransplantation
robot-assisted
ureteral reconstruction
ureteral strictures
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spelling Robotic ileal ureter replacement vs kidney autotransplantation for long ureteric stricturesAfferi, LGallioli, ATerrito, ACannoletta, DMestdagh, KVangeneugden, JVan Praet, CDesender, LMercier, JPrudhomme, TSalamone, VFontana, GAlbisinni, SOsswald, RJohn, HEtcheverry, BVigués, FDoumerc, NMinervini, APalou, JDecaestecker, KBreda, Aileal ureter replacementkidney autotransplantationrobot-assistedureteral reconstructionureteral stricturesObjective To compare functional and surgical outcomes of robot-assisted ileal ureter replacement (RAIUR) vs robot-assisted kidney autotransplantation (RAKAT). Patients and Methods This was a retrospective analysis of patients who underwent RAIUR or RAKAT for long ureteric strictures at eight European tertiary centres (2017-2024). Primary endpoints were maintenance of estimated glomerular filtration rate (eGFR) and postoperative complications within 30 days of surgery, described using the Clavien-Dindo classification. Secondary outcomes included infections, need for lifelong drainage, stricture persistence, and re-intervention for the stricture during follow-up. Results A total of 15 and 39 patients underwent RAIUR and RAKAT, respectively. The patients who underwent RAIUR were older (61 vs 45 years, P = 0.03), with more comorbidities (Charlson Comorbidity Index >= 3: 67% vs 28%, P = 0.03) and had a lower baseline eGFR (60 vs 87 mL/min/1.73m(2), P = 0.007). The median stricture length was 9.6 cm for RAIUR vs 7 cm for RAKAT. Patients who underwent RAIUR had a shorter surgical time (290 vs 355 min, P = 0.008), whereas those who underwent RAKAT had a shorter hospitalisation (5 vs 8 days, P = 0.001). Overall complications were higher after RAIUR (73% vs 31%, P = 0.01), but Clavien-Dindo Grade >= III complications were similar (13% vs 10%). During follow-up, both groups showed slightly improved renal function, low infection rates (13% for RAIUR vs 10% for RAKAT), low stricture persistence (13% for RAIUR vs 7.7% for RAKAT), and minimal need for drainage or re-intervention. The main limitation was the modest sample size. Conclusion In the first comparative analysis of RAIUR and RAKAT, we provide evidence that both techniques provide similar improvements in renal function and similar rates of postoperative high-grade complications. Both approaches represent definitive solutions for ureteric strictures in most patients. The choice of the technique should be based on patients' factors, patients' expectations and the surgeon's experience.WILEY2025info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=19343BJU INTERNATIONALISSN: 14644096ISSNe: 1464410Xreponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pauinstname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)Inglésinfo:eu-repo/semantics/openAccessoai:iibsantpau.fundanetsuite.com:p193432026-06-14T12:41:47Z
dc.title.none.fl_str_mv Robotic ileal ureter replacement vs kidney autotransplantation for long ureteric strictures
title Robotic ileal ureter replacement vs kidney autotransplantation for long ureteric strictures
spellingShingle Robotic ileal ureter replacement vs kidney autotransplantation for long ureteric strictures
Afferi, L
ileal ureter replacement
kidney autotransplantation
robot-assisted
ureteral reconstruction
ureteral strictures
title_short Robotic ileal ureter replacement vs kidney autotransplantation for long ureteric strictures
title_full Robotic ileal ureter replacement vs kidney autotransplantation for long ureteric strictures
title_fullStr Robotic ileal ureter replacement vs kidney autotransplantation for long ureteric strictures
title_full_unstemmed Robotic ileal ureter replacement vs kidney autotransplantation for long ureteric strictures
title_sort Robotic ileal ureter replacement vs kidney autotransplantation for long ureteric strictures
dc.creator.none.fl_str_mv Afferi, L
Gallioli, A
Territo, A
Cannoletta, D
Mestdagh, K
Vangeneugden, J
Van Praet, C
Desender, L
Mercier, J
Prudhomme, T
Salamone, V
Fontana, G
Albisinni, S
Osswald, R
John, H
Etcheverry, B
Vigués, F
Doumerc, N
Minervini, A
Palou, J
Decaestecker, K
Breda, A
author Afferi, L
author_facet Afferi, L
Gallioli, A
Territo, A
Cannoletta, D
Mestdagh, K
Vangeneugden, J
Van Praet, C
Desender, L
Mercier, J
Prudhomme, T
Salamone, V
Fontana, G
Albisinni, S
Osswald, R
John, H
Etcheverry, B
Vigués, F
Doumerc, N
Minervini, A
Palou, J
Decaestecker, K
Breda, A
author_role author
author2 Gallioli, A
Territo, A
Cannoletta, D
Mestdagh, K
Vangeneugden, J
Van Praet, C
Desender, L
Mercier, J
Prudhomme, T
Salamone, V
Fontana, G
Albisinni, S
Osswald, R
John, H
Etcheverry, B
Vigués, F
Doumerc, N
Minervini, A
Palou, J
Decaestecker, K
Breda, A
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv ileal ureter replacement
kidney autotransplantation
robot-assisted
ureteral reconstruction
ureteral strictures
topic ileal ureter replacement
kidney autotransplantation
robot-assisted
ureteral reconstruction
ureteral strictures
description Objective To compare functional and surgical outcomes of robot-assisted ileal ureter replacement (RAIUR) vs robot-assisted kidney autotransplantation (RAKAT). Patients and Methods This was a retrospective analysis of patients who underwent RAIUR or RAKAT for long ureteric strictures at eight European tertiary centres (2017-2024). Primary endpoints were maintenance of estimated glomerular filtration rate (eGFR) and postoperative complications within 30 days of surgery, described using the Clavien-Dindo classification. Secondary outcomes included infections, need for lifelong drainage, stricture persistence, and re-intervention for the stricture during follow-up. Results A total of 15 and 39 patients underwent RAIUR and RAKAT, respectively. The patients who underwent RAIUR were older (61 vs 45 years, P = 0.03), with more comorbidities (Charlson Comorbidity Index >= 3: 67% vs 28%, P = 0.03) and had a lower baseline eGFR (60 vs 87 mL/min/1.73m(2), P = 0.007). The median stricture length was 9.6 cm for RAIUR vs 7 cm for RAKAT. Patients who underwent RAIUR had a shorter surgical time (290 vs 355 min, P = 0.008), whereas those who underwent RAKAT had a shorter hospitalisation (5 vs 8 days, P = 0.001). Overall complications were higher after RAIUR (73% vs 31%, P = 0.01), but Clavien-Dindo Grade >= III complications were similar (13% vs 10%). During follow-up, both groups showed slightly improved renal function, low infection rates (13% for RAIUR vs 10% for RAKAT), low stricture persistence (13% for RAIUR vs 7.7% for RAKAT), and minimal need for drainage or re-intervention. The main limitation was the modest sample size. Conclusion In the first comparative analysis of RAIUR and RAKAT, we provide evidence that both techniques provide similar improvements in renal function and similar rates of postoperative high-grade complications. Both approaches represent definitive solutions for ureteric strictures in most patients. The choice of the technique should be based on patients' factors, patients' expectations and the surgeon's experience.
publishDate 2025
dc.date.none.fl_str_mv 2025
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=19343
url https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=19343
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv WILEY
publisher.none.fl_str_mv WILEY
dc.source.none.fl_str_mv BJU INTERNATIONAL
ISSN: 14644096
ISSNe: 1464410X
reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
instname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
instname_str Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
reponame_str r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
collection r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,811543

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