Ziho Lee, MD, describes study of robotic intracorporeal ileal ureter replacement

In this video, Ziho Lee, MD, discusses the 2024 World Congress of Endourology & Uro-Technology abstract “Multi-institutional outcomes of robotic intracorporeal ileal ureter replacement in patients with more than one year follow-up.” Lee is an assistant professor of urology and the director of Urologic Male Reconstruction and Robotic Reconstructive Surgery in the department of urology at Northwestern University Feinberg School of Medicine in Chicago, Illinois.

Transcription:

We participated in a multi-institutional study regarding robotic ilieal ureter replacement with NYU and Colorado. This was a pretty unique study because the literature on robotic ileal ureter replacement is pretty scant. I think the largest case series right now includes about 7 patients. I think there are 2 major reasons for this. First of all, with the popularization of buccal mucosa graft ureteroplasty and appendiceal ureteroplasty, the indications for ileal ureter replacement have decreased significantly. Additionally, the procedure can be pretty complex and associated with significant morbidity. Despite this, there is still a subset of patients who do need ileal replacement or could benefit from ileal replacement. And because of this, we set out to present our results and our peri-operative outcomes in this space. We had a multi-institutional cohort with NYU and the University of Colorado, and we had 39 patients in our cohort.

And so it does add considerably to our existing literature. What's really notable in our series is that about 27% of our patients had some degree of pelvic radiation, and so it shows that our surgery can be performed in the setting of prior radiation. Additionally, our complication rate was about 15% for major complications. These included anastomotic leaks that required drains and intra-abdominal abscess that required drains and a small bowel leak that required exploratory laparotomy. What's really notable is that in our study, our median follow-up was almost 2 years, and at this median follow-up, we had a 92% success rate. Based on our work, it does show that ileal ureter replacement can be an effective long-term option for patients with long-segment ureteral stricture disease. However, the procedure can be pretty challenging, associated with significant morbidity, as we found a 15% major complication rate.

This transcription was edited for clarity.