Abstract
Purpose
We sought to determine whether preoperative stricture length measurement affected the choice of procedure performed, its correlation to intraoperative stricture length, and postoperative outcomes.
Methods
The Collaborative of Reconstructive Robotic Ureteral Surgery (CORRUS) database was queried for patients undergoing robotic ureteral reconstructive surgery from 2013 to 2021 who had surgical stricture length measurement. From this cohort, we identified patients with and without preoperative stricture length measurement via retrograde pyelogram or antegrade nephrostogram. Outcomes evaluated included intraoperative complications, 30-day complications greater than Clavien-Dindo grade II, hardware-free status, and need for additional procedures.
Results
Of 153 patients with surgical stricture length measurements, 102 (66.7%) had preoperative radiographic measurement. No repair type was more likely to have preoperative measurement. The Pearson correlation coefficient between surgical and radiographic stricture length measurements was + 0.79. The average surgical measurement was 0.71 cm (± 1.52) longer than radiographic assessment. Those with preoperative imaging waited on average 5.0 months longer for surgery, but this finding was not statistically significant (p = 0.18). There was no statistically significant difference in intraoperative complications, 30-day complication rates, hardware-free status at last follow-up, or need for additional procedures between patients with and without preoperative measurement. The only significant predictive factor was preoperative stricture length on 30-day postoperative complications.
Conclusions
Despite relatively high prevalence of preoperative radiographic stricture length measurement, there are few measures where it offers clinically meaningful diagnostic information towards the definitive surgical management of ureteral stricture disease.
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Data availability
The data that support the findings of this study are available on request from the corresponding author, LCZ.
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Funding
No funding was received for conducting this study.
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TRZ: data management and interpretation, manuscript writing, critical review of manuscript. KM: project development, data collection and interpretation, critical review of manuscript. GB: data analysis and interpretation, critical review of manuscript. AA: data management and interpretation, critical review of manuscript. MS: project development, data collection, critical review of manuscript. DE: project development, data collection, critical review of manuscript. LCZ: project development, data collection, critical review of manuscript.
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The authors have no relevant financial or non-financial interests to disclose.
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Ethics approval was waived by the Institutional Review Board of NYU Langone Medical Center in view of the retrospective nature of the study.
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Zhang, T.R., Mishra, K., Blasdel, G. et al. Preoperative stricture length measurement does not predict postoperative outcomes in robotic ureteral reconstructive surgery. World J Urol 41, 2549–2554 (2023). https://doi.org/10.1007/s00345-023-04525-6
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DOI: https://doi.org/10.1007/s00345-023-04525-6