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Purpose <p>To compare perioperative and follow-up outcomes of ileal ureter replacement (IUR) among open (O-IUR), laparoscopic (L-IUR) and robotic (R-IUR) approaches.</p> Methods <p>We conducted a bidirectional cohort study of patients undergoing IUR for long ureteral strictures between September 2010 and April 2023 in our multi-institutional database. Clinical and follow-up outcomes were compared among the O-IUR, L-IUR and R-IUR groups. Clinical success was defined as symptom-free, stable renal function and no radiographic evidence of obstruction.</p> Results <p>Among 106 patients (23 in O-IUR, 49 in L-IUR and 34 in R-IUR), the three groups had comparable demographic and baseline characteristics. The median operation time was significantly shorter in R-IUR compared to O-IUR (<i>p</i> = 0.029) and L-IUR (<i>p</i> &lt; 0.001). The median estimated blood loss was statistically lower in R-IUR compared to O-IUR (<i>p</i> = 0.002) and L-IUR (<i>p</i> &lt; 0.001). The median length of stay was statistically shorter in R-IUR compared to O-IUR (<i>p</i> &lt; 0.001) and L-IUR (<i>p</i> &lt; 0.001). The rate of postoperative Clavien-Dindo grade III complications was higher in O-IUR compared to L-IUR (<i>p</i> = 0.257) and R-IUR (<i>p</i> = 0.022).</p> Conclusion <p>Robotic ileal ureter replacement demonstrates clear perioperative advantages, consistent with the well-established superiority of robotic platforms in complex reconstructive procedures. However, differences in follow-up duration and potential time/experience bias should be acknowledged when interpreting complication rates.</p>

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Comparison of open, laparoscopic, and robot-assisted ileal ureter replacement for long ureteral strictures: a multi-institutional bidirectional cohort study

  • 期刊论文

  • 发表日期：

    2026年6月15日

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  • Xiang Wang,
  • Jiyu Yang,
  • Guanpeng Han,
  • Zhihua Li,
  • Yiming Zhang,
  • Xinfei Li,
  • Bing Wang,
  • Peng Zhang,
  • Chen Huang,
  • Jing Liu,
  • Hongjian Zhu,
  • Kunlin Yang,
  • Liqun Zhou,
  • Kai Zhang,
  • Xuesong Li

摘要

Purpose

To compare perioperative and follow-up outcomes of ileal ureter replacement (IUR) among open (O-IUR), laparoscopic (L-IUR) and robotic (R-IUR) approaches.

Methods

We conducted a bidirectional cohort study of patients undergoing IUR for long ureteral strictures between September 2010 and April 2023 in our multi-institutional database. Clinical and follow-up outcomes were compared among the O-IUR, L-IUR and R-IUR groups. Clinical success was defined as symptom-free, stable renal function and no radiographic evidence of obstruction.

Results

Among 106 patients (23 in O-IUR, 49 in L-IUR and 34 in R-IUR), the three groups had comparable demographic and baseline characteristics. The median operation time was significantly shorter in R-IUR compared to O-IUR (p = 0.029) and L-IUR (p < 0.001). The median estimated blood loss was statistically lower in R-IUR compared to O-IUR (p = 0.002) and L-IUR (p < 0.001). The median length of stay was statistically shorter in R-IUR compared to O-IUR (p < 0.001) and L-IUR (p < 0.001). The rate of postoperative Clavien-Dindo grade III complications was higher in O-IUR compared to L-IUR (p = 0.257) and R-IUR (p = 0.022).

Conclusion

Robotic ileal ureter replacement demonstrates clear perioperative advantages, consistent with the well-established superiority of robotic platforms in complex reconstructive procedures. However, differences in follow-up duration and potential time/experience bias should be acknowledged when interpreting complication rates.