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World Journal of Urology

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Open Access 01-06-2019 | Original Article

Treating benign ureteroenteric strictures: 27-year experience comparing endourological techniques with open surgical approach

Authors: M. J. van Son, M. T. W. T. Lock, M. Peters, E. E. Fransen van de Putte, R. P. Meijer

Published in: World Journal of Urology | Issue 6/2019

Abstract

Purpose

To compare open surgical anastomotic revision with endourological techniques for the treatment of ureteroenteric strictures in patients with urinary diversions.

Methods

All records of patients treated for ureteroenteric strictures in our clinic between 1989 and 2016 were retrospectively reviewed. In 76 patients, 161 completed procedures were analyzed: 26 open revisions vs. 135 endourological treatments, including balloon dilation, Wallstent and/or laser vaporization.

Results

Median follow-up was 34 months. At 60 months, patency rates were 69% (95% CI 52–92%) after open vs. 27% (95% CI 19–39%) after endo-treatment (p = 0.003); median patency duration was 15.5 vs. 5 months, respectively (p = 0.014). Eventually, 15% of patients required open surgery after primary endo-treatment and 21% received endoscopic re-treatment after primary open surgery. Cox regression analysis revealed no confounding factors among the risk factors added to the model. Complication rates were higher after open surgery (27% Clavien 2, 12% Clavien 3–4 vs. 5% Clavien 1–2, 3% Clavien 3, p = 0.528). Median postoperative hospital stay was 14 days (open) vs. 2 days (endo), p < 0.001. Mean estimated glomerular filtration rate improved with + 17 (open) vs. + 8.1 (endo), p = 0.024. Renal function was compromised in 8% of patients in the open surgery group vs. 6% in the endo-treatment group.

Conclusions

In these patients, in terms of patency and patency duration, open surgery was superior to endourology. Nevertheless, endourological treatments offer a safe and less-invasive alternative to delay or avoid open surgery, especially in patients who are unfit for open surgery.

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Title: Treating benign ureteroenteric strictures: 27-year experience comparing endourological techniques with open surgical approach
Authors: M. J. van Son
M. T. W. T. Lock
M. Peters
E. E. Fransen van de Putte
R. P. Meijer
Publication date: 01-06-2019
Publisher: Springer Berlin Heidelberg
Published in: World Journal of Urology / Issue 6/2019
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-018-2475-4

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Treating benign ureteroenteric strictures: 27-year experience comparing endourological techniques with open surgical approach

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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