Presented by: Mouneeb Choudry MD
Mayo Clinic Arizona

Introduction

To compare patient outcomes and complications after open vs. robotic ureteral reimplantation of  transplanted kidneys.  Ureteral strictures of the transplant kidney may require complex reconstruction.  This was classically performed with an open approach, but robotic techniques have emerged. Data comparing these approaches is scare, therefore we investigate the clinical outcomes of the robotic compared to open transplant ureteral reimplant.

Materials

All patients who underwent ureteral reimplant of a transplant kidney at three tertiary care centers were retrospectively reviewed over a 10 year period.  We compared patient demographics, perioperative and postoperative data with at least one year follow up.  T-test and chi squared analysis were used to evaluate continuous and categorical data respectively.

Results

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Ninety six patients underwent transplant ureteral reimplant.  Fifty one patients underwent open repair and 45 underwent robotic transplant reimplant.  There were no differences in patient demographics.  The open approach had shorter operative times than the robotic (161 min vs 271 min, p < .001) with similar post surgical hospitalization length of stay (2 days vs 2 days, p = .137).  The open and robotic approaches had similar post-operative creatinine nadir (1.4 mg/dL vs 1.39 mg/dL, p = .997), and stricture recurrence (p= 1.0). 

Conclusion

Robotic and open transplant reimplant techniques demonstrate similar postoperative clinical outcomes and complication rates.  Shared decision making and surgeon technical experience should be the guiding factor in surgical planning.

Funding

We have no funding to disclose for this project.

Lead Authors

Daniel Heidenberg, MD
Mayo Clinic Arizona

Co-Authors

Kian Ahmadieh, MD
Mayo Clinic Arizona

Scott Cheney, MD
Mayo Clinic Arizona