V09-04 ROBOTIC NON TRANSECTING SECONDARY PYELOPLASTY TECHNIQUES FOR RECURRENT URETEROPELVIC JUNCTION OBSTRUCTION

Abstract

You have accessJournal of UrologyUpper Tract Reconstruction (V09)1 Sep 2021V09-04 ROBOTIC NON TRANSECTING SECONDARY PYELOPLASTY TECHNIQUES FOR RECURRENT URETEROPELVIC JUNCTION OBSTRUCTION Matthew Lee, Ziho Lee, Aeen Asghar, Randall Lee, David Strauss, Michael Stifelman, Lee C Zhao, and Daniel Eun Matthew LeeMatthew Lee More articles by this author , Ziho LeeZiho Lee More articles by this author , Aeen AsgharAeen Asghar More articles by this author , Randall LeeRandall Lee More articles by this author , David StraussDavid Strauss More articles by this author , Michael StifelmanMichael Stifelman More articles by this author , Lee C ZhaoLee C Zhao More articles by this author , and Daniel EunDaniel Eun More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002052.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Management of patients with recurrent ureteropelvic junction obstruction (UPJO) after prior failed pyeloplasty is challenging. We demonstrate three robotic non transecting pyeloplasty techniques that may be utilized for surgical management of patients in this setting. METHODS: We retrospectively reviewed our Collaborative of Reconstructive Robotic Ureteral Surgery (CORRUS) database for all consecutive patients between 04/2012—09/2019 who underwent a secondary pyeloplasty for management of a recurrent UPJO after prior failed pyeloplasty. The techniques used for secondary pyeloplasty included transecting (dismembered) and non transecting pyeloplasty (YV plasty, buccal mucosa graft ureteroplasty onlay or Heineke-Mikulicz). Postoperatively, patients were assessed for surgical success which we defined as the absence of flank pain and obstruction on imaging. Perioperative variables between transecting and non transecting pyeloplasty groups were compared using nonparametric independent sample median tests and chi-square tests; p<0.05 was considered statistically significant. RESULTS: Overall, 28 patients met inclusion criteria (Table 1). There was no difference in median operative time (p=0.26) and estimated blood loss (p>0.99) between both groups. Near infrared fluorescence with indocyanine green was utilized more frequently in the non transecting group (85.7% versus 50.0%, p=0.04). The non transecting group had a longer median stricture length (2.8 versus 1.1 centimeters, p=0.04). There was no difference in surgical success rates between both groups (p>0.99). CONCLUSIONS: Non transecting pyeloplasty techniques including YV plasty, buccal mucosa graft ureteroplasty onlay and Heineke-Mikulicz pyeloplasty may be safely and effectively utilized in patients with recurrent UPJO after prior failed pyeloplasty. Non transecting pyeloplasty techniques may preserve the fragile ureteral blood supply and help avoid ureteral devascularization in this setting. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e688-e688 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Matthew Lee More articles by this author Ziho Lee More articles by this author Aeen Asghar More articles by this author Randall Lee More articles by this author David Strauss More articles by this author Michael Stifelman More articles by this author Lee C Zhao More articles by this author Daniel Eun More articles by this author Expand All Advertisement Loading ...