Mp25-09 multi-institutional comparison of non-transecting versus transecting primary robotic pyeloplasty for ureteropelvic junction obstruction: the collaborative of reconstructive robotic ureteral surgery (corrus) experience

You have accessJournal of UrologyCME1 May 2022MP25-09 MULTI-INSTITUTIONAL COMPARISON OF NON-TRANSECTING VERSUS TRANSECTING PRIMARY ROBOTIC PYELOPLASTY FOR URETEROPELVIC JUNCTION OBSTRUCTION: THE COLLABORATIVE OF RECONSTRUCTIVE ROBOTIC URETERAL SURGERY (CORRUS) EXPERIENCE David Strauss, Matthew Lee, Ziho Lee, Aeen Asghar, Randall Lee, Lee Zhao, Michael Stifelman, and Daniel Eun David StraussDavid Strauss More articles by this author , 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 , Lee ZhaoLee Zhao More articles by this author , Michael StifelmanMichael Stifelman More articles by this author , and Daniel EunDaniel Eun More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002568.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: There is a paucity of literature describing non-transecting pyeloplasty in the primary setting of ureteropelvic junction obstruction (UPJO) repair. Our objective is to describe the surgical techniques and peri-operative outcomes of primary non-transecting robotic pyeloplasty (RP) compared to standard dismembered RP. METHODS: The Collaborative of Reconstructive Robotic Ureteral Surgery (CORRUS) multi-institutional database was queried retrospectively for all patients who underwent primary RP between 04/2012-08/2020. Patients were grouped according to surgical approach; Anderson-Hynes dismembered (transecting) RP or non-transecting RP (Fenger or Y-V Flap). Perioperative outcomes were compared using nonparametric independent sample median tests and chi-square tests; p<0.05 was considered significant. RESULTS: Of 133 patients, 115 (86.5%) underwent transecting and 18 (13.5%) underwent non-transecting RP. Median operative time (138.0 vs 134.0 min, p=0.66) and estimated blood loss (50 vs 50cc, p=0.12) were similar between transecting and non-transecting groups, respectively. Likewise, there was no difference in major (Clavien>2) complications between the surgical technique groups (p=0.08). At a median follow-up of 12.9 months, there was no difference in success between transecting and non transecting groups (92.2% versus 88.9%, respectively; p=0.64). CONCLUSIONS: Given variable anatomical configurations of ureteropelvic junction obstruction (UPJO), including ureteral, vascular, and perihilar variations, a “one-size-fits-all” approach to pyeloplasty is inappropriate. Primary non-transecting RP, compared to standard dismembered RP, showed similar operative time, EBL, complication rates, as well as surgical success. The authors do not intend to suggest non transecting pyeloplasty replace dismembered pyeloplasty in the primary setting, especially for indications such as a crossing vessel; however rather hope to demonstrate that a primary non transecting approach in select patients is not inferior to a dismembered approach, and serves as an important technique in the armamentarium of the robotic urologist approaching difficult UPJO repairs. Source of Funding: N/A © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e430 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information David Strauss More articles by this author 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 Lee Zhao More articles by this author Michael Stifelman More articles by this author Daniel Eun More articles by this author Expand All Advertisement PDF downloadLoading ...