MP21-14 MANAGEMENT OF URETERO-ENTERIC STRICTURES AFTER ROBOT-ASSISTED RADICAL CYSTECTOMY

Abstract

You have accessJournal of UrologyBladder Cancer: Invasive I1 Apr 2017MP21-14 MANAGEMENT OF URETERO-ENTERIC STRICTURES AFTER ROBOT-ASSISTED RADICAL CYSTECTOMY Youssef Ahmed, Ahmed Hussein, Paul May, Basim Ahmad, Taimoor Ali, Prasanna Kumar, and Khurshid Guru Youssef AhmedYoussef Ahmed More articles by this author , Ahmed HusseinAhmed Hussein More articles by this author , Paul MayPaul May More articles by this author , Basim AhmadBasim Ahmad More articles by this author , Taimoor AliTaimoor Ali More articles by this author , Prasanna KumarPrasanna Kumar More articles by this author , and Khurshid GuruKhurshid Guru More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.3276AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES When conservative management for uretero-enteric strictures (UES) following robot-assisted radical cystectomy (RARC) fails, the gold standard is open revision, which may be associated with higher morbidity and technical complexity. We sought to investigate the predictors of successful endoscopic management for UES after RARC. METHODS We retrospectively reviewed our RARC database and identified patients who developed UES. All patients were initially managed with an endoscopic/percutaneous approach. Successful management was defined as absence of significant urinary tract obstruction on postoperative imaging. Data was reviewed for demographics operative approach, and perioperative outcomes. A logistic regression model was fit to evaluate predictors for successful endoscopic management. RESULTS Our database included 418 patients. UES were identified in 51 (12%) patients. Median time to UES following RARC was 5 months (IQR 2-12). Median time to primary management was 22 (IQR 4-54) days after diagnosis. Sixteen patients had a robot-assisted (RA) repair and 6 had open (Table 1). Thirty three patients had successful management of UES after an average of 2 procedures (endoscopic 13; robot-assisted revision 15; and open revision 5) (Figure 1). Only female gender (OR 0.13, 95% CI 0.03-0.56, p=0.007) and BMI (OR 0.88, 95% CI 0.77-0.99, p=0.05) were significant predictors of successful endoscopic management. CONCLUSIONS None of the stricture characteristics or the cancer stage predicted successful endoscopic management of UES after RARC. Only patient-related factors (male gender and lower BMI) were associated with successful endoscopic management. © 2017FiguresReferencesRelatedDetailsCited byHautmann R (2017) Declining Use of Orthotopic Reconstruction Worldwide—What Went Wrong?Journal of Urology, VOL. 199, NO. 4, (900-903), Online publication date: 1-Apr-2018. Volume 197Issue 4SApril 2017Page: e252-e253 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Youssef Ahmed More articles by this author Ahmed Hussein More articles by this author Paul May More articles by this author Basim Ahmad More articles by this author Taimoor Ali More articles by this author Prasanna Kumar More articles by this author Khurshid Guru More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...