Management for Benign Ureteral Stricture: Comparison of robot-assisted laparoscopy, conventional laparoscopy, and balloon dilation.

Abstract

Robot-assisted laparoscopy (RALP), conventional laparoscopy (LP), and balloon dilation (BD) have all been identified as common treatments for benign ureteral stricture (BUS). The purpose of the research would be to compare the safety and efficacy differences in the three groups. Patients who received RALP, LP, or BD for BUS were studied retrospectively from January 2016 through December 2020. Professional and experienced surgeons performed all operations. We collect and analyze baseline characteristics, stricture details, peri-operative, and follow-up information. The results showed no statistically significant differences between the three groups for baseline characteristics and stricture details. No statistical differences were also found between RALP and LP in specific surgical techniques. The average operative time was longer in the LP group than RALP and BD groups (178 min vs 150 min vs 67 min, respectively, P<0.001). BD had a lower estimated blood loss than RALP and LP (14 ml vs 40 ml vs 32 ml, p<0.001) and similar between the RALP and LP groups (p=0.238). The BD group had the shortest postoperative hospital stay compared with the RALP and LP groups (3 d vs 5 d vs 7 d, P<0.001), and no statistically significant differences existed between the RALP and LP groups (P=0.098). RALP had considerably greater hospitalization expenses than both LP (P<0.001) and BD (P<0.001). Complications and short-term success rates (6 months) were similar. The BD group had poorer long-term success (12 and 24 months) than the RALP and LP groups, whereas there was no statistically significant difference between the RALP and LP groups. For the management of BUS, RALP, LP, and BD are all safe and effective, with equivalent complication rates and short-term success. In long-term success rates, BD is low than RPLP and LP.