MP55-13 ROBOTIC ASSISTED LAPAROSCOPIC IPSILATERAL URETEROURETEROSTOMY: A REPORT OF EFFICACY AND COMPARISON TO OPEN SURGERY

Abstract

You have accessJournal of UrologyPediatrics: Urinary Tract Infection and Vesicoureteral Reflux1 Apr 2016MP55-13 ROBOTIC ASSISTED LAPAROSCOPIC IPSILATERAL URETEROURETEROSTOMY: A REPORT OF EFFICACY AND COMPARISON TO OPEN SURGERY Arun Srinivasan, Dhirendra Shrivastava, Carmen Tong, and Aseem Shukla Arun SrinivasanArun Srinivasan More articles by this author , Dhirendra ShrivastavaDhirendra Shrivastava More articles by this author , Carmen TongCarmen Tong More articles by this author , and Aseem ShuklaAseem Shukla More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.604AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Ipsilateral upper to lower pole ureteroureterostomy (U-U) is a potential treatment for an ectopic ureter or ureterocele associated with a duplex renal collecting system. Robotic assisted laparoscopic (RALUU) approach to this procedure is increasingly being considered as a potential option. We present, herein, the largest single-institution report of RAL ureteroureterostomy and compare it to the traditional open approach. METHODS We reviewed an IRB approved surgical registry at our institution for consecutive open and RAL UU cases completed between 2012 and 2015. We recorded surgical approach, function in obstructed upper pole prior to surgery, duration of surgery, length of hospital stay, total morphine equivalents required and surgical success in decompressing the upper pole. Statistical comparisons were made using Mann Whitney U test assuming nonparametric distribution. RESULTS There were 27 RALU-U and 18 open U-U (OUU) cases completed over the study interval. The RALU-U was performed with a dissection and anastomosis at the level of the pelvic brim; the open U-U was completed more distally, adjacent to the uretero-vesical junction, The RALU-U was performed on older children (median age 2.36 for RALU-U and 0.38 years for open), and required 20 minutes longer operative time (p<0.05). Despite the age difference in our cohorts, there was no difference in post-operative analgesic requirement adjusted to body weight and median length of stay in both groups was 24 hours. The open U-U was associated with a significantly greater risk of developing a postoperative urinary tract infection. Surgical success in decompressing the upper pole calyces and ureter was independent of whether there was detectable upper pole renal function prior to surgery. CONCLUSIONS The RALU-U is as effective as open U-U in treating obstructing anomalies associated with a duplex collecting system regardless of residual function in the obstructed upper pole. The RALU-U is associated with a lower risk of post-operative urinary tract infection © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e740-e741 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Arun Srinivasan More articles by this author Dhirendra Shrivastava More articles by this author Carmen Tong More articles by this author Aseem Shukla More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...