PDF(Pubmed)
Abstract：
UNASSIGNED: We described the technique and outcomes of robot-assisted repair of uretero-enteric strictures (UES) following robot-assisted radical cystectomy (RARC) and urinary diversion.
UNASSIGNED: Retrospective review of our RARC database from November 2005 to August 2023 at Roswell Park Comprehensive Cancer center was performed. Patients who developed UES and ultimately underwent robot-assisted uretero-enteric reimplantation (RUER) were identified. Kaplan-Meier method was used to compute the cumulative incidence recurrence rate of UES after RUER. A multivariable regression model was used to identify variables associated with UES recurrence.
UNASSIGNED: A total of 123 (15%) out of 808 RARC patients developed UES, of whom 52 underwent reimplantation (45 patients underwent RUER [n=55 cases] and seven patients underwent open uretero-enteric reimplantation). The median time from RARC to UES was 4.4 (interquartile range 3.0-7.0) months, and the median time between UES and RUER was 5.2 (interquartile range 3.2-8.9) months. The 3-year recurrence rate after RUER is about 29%. On multivariable analysis, longer hospital stay (hazard ratio 1.37, 95% confidence interval 1.16-1.61, p<0.01) was associated with recurrent UES after RUER.
UNASSIGNED: RUER for UES after RARC is feasible with durable outcomes although a notable subset of patients experienced postoperative complications and UES recurrence.
UNASSIGNED: Retrospective review of our RARC database from November 2005 to August 2023 at Roswell Park Comprehensive Cancer center was performed. Patients who developed UES and ultimately underwent robot-assisted uretero-enteric reimplantation (RUER) were identified. Kaplan-Meier method was used to compute the cumulative incidence recurrence rate of UES after RUER. A multivariable regression model was used to identify variables associated with UES recurrence.
UNASSIGNED: A total of 123 (15%) out of 808 RARC patients developed UES, of whom 52 underwent reimplantation (45 patients underwent RUER [n=55 cases] and seven patients underwent open uretero-enteric reimplantation). The median time from RARC to UES was 4.4 (interquartile range 3.0-7.0) months, and the median time between UES and RUER was 5.2 (interquartile range 3.2-8.9) months. The 3-year recurrence rate after RUER is about 29%. On multivariable analysis, longer hospital stay (hazard ratio 1.37, 95% confidence interval 1.16-1.61, p<0.01) was associated with recurrent UES after RUER.
UNASSIGNED: RUER for UES after RARC is feasible with durable outcomes although a notable subset of patients experienced postoperative complications and UES recurrence.
摘要：
■我们描述了机器人辅助根治性膀胱切除术（RARC）和尿流改道后，机器人辅助修复输尿管-肠狭窄（UES）的技术和结果。
■对我们2005年11月至2023年8月在罗斯威尔公园综合癌症中心的RARC数据库进行了回顾性审查。确定了发生UES并最终接受机器人辅助输尿管肠再植（RUER）的患者。使用Kaplan-Meier方法计算RUER后UES的累积复发率。使用多变量回归模型来识别与UES复发相关的变量。
■在808名RARC患者中，共有123名（15％）出现了UES，其中52例接受了再植术（45例患者接受了RUER[n=55例]，7例患者接受了输尿管-肠开放再植术）。从RARC到UES的中位时间为4.4（四分位距3.0-7.0）个月，UES和RUER的中位时间为5.2个月(四分位距3.2-8.9个月).RUER术后3年复发率约为29%。在多变量分析中，住院时间延长(风险比1.37,95%置信区间1.16-1.61,p<0.01)与RUER术后复发性UES相关.
■RUER治疗RARC术后UES是可行的，具有持久的结局，尽管一部分明显的患者出现了术后并发症和UES复发。
■对我们2005年11月至2023年8月在罗斯威尔公园综合癌症中心的RARC数据库进行了回顾性审查。确定了发生UES并最终接受机器人辅助输尿管肠再植（RUER）的患者。使用Kaplan-Meier方法计算RUER后UES的累积复发率。使用多变量回归模型来识别与UES复发相关的变量。
■在808名RARC患者中，共有123名（15％）出现了UES，其中52例接受了再植术（45例患者接受了RUER[n=55例]，7例患者接受了输尿管-肠开放再植术）。从RARC到UES的中位时间为4.4（四分位距3.0-7.0）个月，UES和RUER的中位时间为5.2个月(四分位距3.2-8.9个月).RUER术后3年复发率约为29%。在多变量分析中，住院时间延长(风险比1.37,95%置信区间1.16-1.61,p<0.01)与RUER术后复发性UES相关.
■RUER治疗RARC术后UES是可行的，具有持久的结局，尽管一部分明显的患者出现了术后并发症和UES复发。
