Comparative Outcomes of Robot-Assisted vs Traditional Laparoscopic Ureteral Reimplantation for Lower Ureteral Stenosis: A Single Center Study.

BACKGROUND Robot-assisted laparoscopic ureteral bladder reimplantation (RALUR) has shown fewer operative and postoperative complications than traditional laparoscopic ureteral reimplantation (LUR) in treating ureteral stenosis. This study from a single center aimed to compare clinical outcomes from RALUR and LUR in treating 34 lower ureteral stenosis patients. MATERIAL AND METHODS Clinical data [visual analogue scale (VAS), complications, glomerular filtration rate (GFR), degree of pelvis separation, and degree of ureteral dilation] from lower ureteral stenosis patients treated with RALUR (n=14) and LUR (n=20) from January 2019 to January 2023 were analyzed. RESULTS Operation time (P=0.025) and postoperative hemoglobin decline (P=0.003) in the RALUR group were significantly lower than in the LUR group. Postoperative drainage tube removal time (P<0.001) and postoperative hospital stay (P=0.017) in the RALUR group were significantly shorter than in the LUR group. The total hospitalization cost of RALUR was significantly higher than that of LUR (P<0.001). There were no differences in postoperative VAS and complications between the 2 groups (P=0.58/P=1.000). Renal pelvis separation length (P<0.001) and degree of ureteral dilation (P<0.001) of the affected side were reduced in the RALUR group at 6 months postoperation, and GFR was significantly improved (P<0.001). In the LUR group, separation of the affected renal pelvis (P<0.001) and degree of ureteral dilation (P<0.001) were significantly reduced 6 months postoperation. The degree of renal pelvis separation in the RALUR group was significantly greater than in the LUR group (P=0.030), but the difference in degree of ureteral dilation (P=0.084) and affected kidney GFR (P=0.928) between the 2 groups was not significant. CONCLUSIONS Compared with LUR, RALUR has advantages of less bleeding, shorter operation time, higher safety, shorter postoperative hospital stay, faster recovery, less perioperative complications, and a more precise curative effect.