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You have accessJournal of UrologyReconstruction: Ureteral Reconstruction (Including Pyeloplasty) and Bladder Reconstruction (Including Trauma-Related Fistula) II (PD44)1 May 2024PD44-06 A DECADE OF MULTI-INSTITUTIONAL EXPERIENCE WITH ROBOTIC URETEROPLASTY WITH BUCCAL MUCOSA GRAFT Michael Raver, Brian Chao, Jeffery Lin, Kelley Zhao, Matthew Lee, Daniel Eun, Lee C. Zhao, and Michael Stifelman Michael RaverMichael Raver , Brian ChaoBrian Chao , Jeffery LinJeffery Lin , Kelley ZhaoKelley Zhao , Matthew LeeMatthew Lee , Daniel EunDaniel Eun , Lee C. ZhaoLee C. Zhao , and Michael StifelmanMichael Stifelman View All Author Informationhttps://doi.org/10.1097/01.JU.0001008800.83683.92.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Robotic ureteroplasty with buccal mucosa graft (RU-BMG) has emerged as a leading option for repair of long ureteral strictures. We have presented on our previous series of 54 patients. We present our updated experience with RU-BMG. METHODS: A multi-institutional IRB-approved retrospective review was conducted of all patients in the CORRUS database who underwent RU-BMG between October 2013 and June 2023. Indications for surgery were patients with long stricture disease not amenable to excision and primary anastomosis. Three techniques were utilized- anterior onlay, posterior onlay, and augmented anastomotic ureteroplasty. Demographic, peri-operative and follow up data was collected prospectively. Success was defined as absence of hardware and no repeat surgical reconstruction attempt. RESULTS: 149 patients underwent RU-BMG. Success rate was 92.6% with median follow up 11.0 months (range 3-25). Mean time to failure was 13.5 months (SD 15.7), with 4 of 11 failures after 1 year. Demographic data is summarized in Table 1. Average stricture length was 3.5 cm, majority proximal (79.7%). Prior repair was attempted in 46.6% of which endoscopic repair had lower EBL compared to formal surgical repair. 130 patients (87.2%) underwent omental wrap, 6 mesenteric flap (4.0%), and 7 perinephric flap (4.7%).Table 2 summarizes outcomes based on stricture location. No significant differences were identified for proximal, mid, and distal strictures; multiple strictures had longer operative times, LOS, and complication rates. Success rates were similar between anterior onlay (92%), posterior onlay (100%), and augmented anastomotic techniques (93%). CONCLUSIONS: We present the largest series to date on RU-BMG for the management of long ureteral strictures. RU-BMG has excellent outcomes, even with failed prior stricture treatment and multiple stricture sites. The majority of failures occur within the first year after surgery. RU-BMG should be offered as initial treatment for long ureteral strictures. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e906 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Michael Raver More articles by this author Brian Chao More articles by this author Jeffery Lin More articles by this author Kelley Zhao More articles by this author Matthew Lee More articles by this author Daniel Eun More articles by this author Lee C. Zhao More articles by this author Michael Stifelman More articles by this author Expand All Advertisement PDF downloadLoading ...
Raver et al. (Mon,) studied this question.