Minimally invasive versus open ileal ureter with ileocystoplasty: comparative outcomes and 5-year experience

• Published in: BMC urology Vol. 24; no. 1; pp. 118 - 8
• Main Authors: Chen, Silu, Wang, Xiang, Li, Zhihua, Li, Xinfei, Han, Guanpeng, Tao, Zihao, Li, Zhenyu, Zhang, Peng, Zhu, Hongjian, Yang, Kunlin, Li, Xuesong
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 10.06.2024; BioMed Central; BMC
• Subjects: Adult; Aged; Bladder; Catheters; Cholecystitis; Creatine; Demographics; Development and progression; Diuretics; Embolism; Female; Hospitalization; Humans; Ileal ureter replacement; Ileocystoplasty; Ileum - surgery; Laparoscopy; Laparoscopy - methods; Male; Middle Aged; Minimally invasive surgery; Minimally Invasive Surgical Procedures - methods; Patients; Pulmonary embolism; Retrospective Studies; Rivaroxaban; Robotic Surgical Procedures; Robotics; Small intestine; Surgery; Sutures; Time Factors; Treatment Outcome; Tuberculosis; Ureter; Ureter - surgery; Ureteral stricture with bladder contracture; Urinary Bladder - surgery; Urine; Urogenital system; Urologic Surgical Procedures - methods; Minimally invasive surgery; Ileocystoplasty; Ureteral stricture with bladder contracture; Ileal ureter replacement
• ISSN: 1471-2490; 1471-2490
• DOI: 10.1186/s12894-024-01509-5

To present the experience of ileal ureter with ileocystoplasty (IUC), and compare the outcomes of IUC in minimally invasive procedures to open procedures. From December 2017 to April 2023, twenty patients underwent IUC in open or minimally invasive (including laparoscopic and robotic) procedures. The baseline characteristics, perioperative data and follow-up outcomes were collected. Success was defined as relief of clinical symptoms, stable postoperative serum creatine and absence of radiographic obstruction. The perioperative and follow-up outcomes of open procedures and minimally invasive procedures were compared. The etiology included pelvic irradiation (14/20), urinary tuberculosis (3/20) and surgical injury (3/20). Bilateral ureter strictures were repaired in 15 cases. The surgeries conducted consisted of open procedures in 9 patients and minimally invasive procedures in 11 patients. Compared to open procedures, minimally invasive surgeries had less median estimated blood loss (EBL) (100 ml vs. 300 min, p = 0.010) and shorter postoperative hospitalization (27 d vs. 13 d, p = 0.004). Two patients in the open group experienced grade 3 complications (sigmoid fistula and acute cholecystitis in one patient, and pulmonary embolism in another patient). Over a median follow-up period of 20.1 months, the median bladder functional capacity was 300 ml, with a 100% success rate of IUC. IUC is feasible in both open and minimally invasive procedures, with acceptable complications and a high success rate. Minimally invasive procedures can have less EBL and shorter postoperative hospitalization than open procedure. However, prospective studies with larger groups and longer follow-up are needed.