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

Son, Marieke van; Lock, M.T.W.T.; Peters, Max; Putte, Elisabeth E. Fransen van de; Meijer, Richard P.

doi:10.1007/s00345-018-2475-4

Cited by 15 publications

(13 citation statements)

References 18 publications

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“…Knap et al (31) reported that patients who underwent pelvic radiotherapy before had a higher risk to form a stricture than those without. This evidence has also been enhanced by Son et al (12), who showed that the history of pelvic radiotherapy was significant of stricture recurrence in the multivariable Cox proportional hazards regression analysis. Previously, open repair was recommended for persisting long-term patency rate.…”

Section: Discussionmentioning

confidence: 74%

“…A total of 18 studies with 697 patients were finally included in this meta-analysis ( 4 , 12 – 28 ). All studies included were retrospective designed.…”

Section: Resultsmentioning

confidence: 99%

“…From the perspective of safety of endoscopic procedures, we demonstrated that it is a relative secure approach in UES. Son et al ( 12 ) reported 27% Clavien 2 complications in the open repair group of UES, and 8% Clavien 3b complications occurred. Nassar et al ( 4 ) described that about 10% serious intraoperative complications happened in the open repair group.…”

Section: Discussionmentioning

confidence: 98%

“…A total of 18 studies with 697 patients were finally included in this meta-analysis (4, [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28]. All studies included were retrospective designed.…”

Section: Study Characteristicmentioning

confidence: 99%

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Endoscopic Procedures in the Treatment of Ureteroenteric Anastomotic Strictures: A Systematic Review and Meta-Analysis

et al. 2021

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Objective: To evaluate the safety and efficacy of endoscopic procedures for ureteroenteric anastomotic strictures (UESs) after radical cystectomy and urinary diversion.Methods: We performed a meta-analysis of relevant articles through March 2020 using PubMed, Embase, and Cochrane Central Register to assess the efficacy of endoscopic procedures in UES according to the PRISMA and PICOS criteria. The main endpoints were success rate and complications, and we also compared the efficacy of different methods and stricture length and side in UES. Cochrane Collaboration's Revman version 5.3 and Stata version 15.1 software were used for statistical analysis.Results: A total of 18 retrospective studies with 697 patients were included. The median follow-up ranges from 12 to 62.5 months. Patients treated with endoscopic procedures had an overall success rate of 46%. The pooled rate of Clavien–Dindo ≥ 3 complications was 3.8% among included studies. Laser vaporization and stent insertion (48 and 47%) had a relatively high success rate than balloon dilatation (35%). In subgroup analysis, the success rate of endoscopic procedures for ≤ 1-cm strictures was significantly higher than that for >1-cm ones [odds ratio (OR), 8.65; 95% confidence interval (CI), 3.53–21.21; P < 0.00001]. In addition, the success rate in cases with strictures of the right side was relatively higher than that in cases with strictures of the left side (OR, 1.72; 95% CI, 1.05–2.81; P = 0.03).Conclusion: Our pooled studies showed that endoscopic operation is feasible and associated with a moderate success rate along with a relatively low incidence of perioperative complications in the treatment of UES, especially with length ≤ 1 cm and right side. Although there is still no consensus on endoscopic technique for UES regarding balloon dilatation, stent insertion, and laser vaporization, we believe that endoscopic management is a safety and available approach for UES with close follow-up.

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Section: Discussionmentioning

confidence: 74%

“…A total of 18 studies with 697 patients were finally included in this meta-analysis ( 4 , 12 – 28 ). All studies included were retrospective designed.…”

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 98%

Section: Study Characteristicmentioning

confidence: 99%

See 2 more Smart Citations

Endoscopic Procedures in the Treatment of Ureteroenteric Anastomotic Strictures: A Systematic Review and Meta-Analysis

et al. 2021

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“…It postpones or even potentially shuns the needs of open or laparoscopic ureteral reimplantation. [8] Besides, many documents prove that endoscopic interventions are associated with less-invasive and cost-effective. [9]Endoscopic treatments commonly used for ureteral strictures include balloon dilation and endo-ureterectomy.…”

Section: Introductionmentioning

confidence: 99%

A Nomogram to Predict Stricture-free Survival in Patients with Ureteral Stricture after Balloon Dilation

Lai

Gao

et al. 2021

Preprint

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Background Balloon dilation is a commonly used minimally invasive endourological treatment of ureteral stricture, but the postoperative recurrence rate is relatively high. And factors contributing to recurrence after treatment are poorly understood. Herein, we sought to develop a novel clinical nomogram to predict ureteral stricture-free survival in patients suffering from ureter stricture and performed balloon dilation. Methods The nomogram was established based on a retrospective analysis of 321 patients diagnosed with ureter strictures from January 2016 to January 2020 in Sun Yat-sen Memorial Hospital using the Cox regression model. Perioperative clinical data and disease outcomes were analyzed. Discrimination of the nomogram was assessed by the concordance index (C-index) and the calibration curve. The results were internally validated using bootstrap resampling. Results Overall, 321 patients with a median follow-up of 590 days were enrolled in the study, among which 97 patients (30.2%) developed recurrence of ureteral stricture during follow-up. Five variables remained significant predictors of ureteral re-stricture after multivariable analyses: stricture nature (P < 0.001), urinary nitrite (P = 0.041), CKD (P = 0.005), stent retention time (P < 0.001), and balloon size (P = 0.029). The calibration craves for the probability of 1-, 3-, and 5-years stricture-free survival (SFS) presented satisfied with the consistency of nomogram prediction and actual observation. The C-index of the model was 0.74 (95% CI 0.70–0.79). Conclusions Our study developed the first nomogram to effectively predict stricture-free survival in patients suffering from ureter stricture after balloon dilation. It is helpful to identify the optimal patients with ureter stricture for balloon dilation and improve treatment outcomes. However, further external validation of the nomogram is warranted.

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Continent Cutaneous Urinary Diversions

Basourakos

Scherr

2021

Bladder Cancer

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

Abstract: 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.

Cited by 15 publications

References 18 publications

Endoscopic Procedures in the Treatment of Ureteroenteric Anastomotic Strictures: A Systematic Review and Meta-Analysis

Endoscopic Procedures in the Treatment of Ureteroenteric Anastomotic Strictures: A Systematic Review and Meta-Analysis

A Nomogram to Predict Stricture-free Survival in Patients with Ureteral Stricture after Balloon Dilation

Continent Cutaneous Urinary Diversions

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