San Diego, CA USA (UroToday.com) With the rise of minimally-invasive surgical approaches, Dr. Tong and associates questioned the benefits of robot-assisted laparoscopic ureterouterostomy (RALUU) for patients with ectopic ureters or ureterocele associated with a duplex renal collecting system. In their comparison against traditional open surgeries, Dr. Tong utilized a secondary data analysis of a surgery registry at their institution.
From 2012 to 2015, the authors reported a total of 27 RALUU and 18 open ureteroureterostomys (OUU). From these cases, they 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. The Mann Whitney U-test was conducted under the assumption of a nonparametric distribution.
The researchers found that RALUU was completed mainly at the pelvic brim with anastomosis while the OUU was completed towards the distal end of the ureter. On average RALUU was chosen for an older population of patients as compared to the OUU and increased surgical time by 20 minutes (p<0.05). Interestingly, the success of compressing upper pole calyces was found to be independent of whether there was upper pole function pre-operatively for both surgical methods. Operative success was defined as a decrease in hydornephrosis post-operatively.
Overall, Dr. Tong and colleagues concluded that RALUU is comparable to OUU in the treatment of ectopic ureters and ureterocele, but holds a much lower risk of post-operative urinary tract infection.
Presented By: Carmen Tong, MD
Written By: Nobel Nguyen, Undergraduate Researcher, Department of Urology, University of California, Irvine at the 2016 AUA Annual Meeting - May 6 - 10, 2016 – San Diego, California, USA