Robotic lower-lip mucosal graft ureteroplasty for ureteral stenosis longer than 2 cm: initial experience of thirteen patients

Zhaolin Zhang; Xin Zeng; Yuting Wu; Gengqing Wu; Zhihua He; Guoxi Zhang; Xiaofeng Zou; Yuanhu Yuan; Hui Xu

doi:10.3389/fsurg.2024.1504867

Robotic lower-lip mucosal graft ureteroplasty for ureteral stenosis longer than 2 cm: initial experience of thirteen patients

Front Surg. 2024 Dec 6:11:1504867. doi: 10.3389/fsurg.2024.1504867. eCollection 2024.

Authors

Zhaolin Zhang^#¹, Xin Zeng^#², Yuting Wu¹, Gengqing Wu¹, Zhihua He¹, Guoxi Zhang¹, Xiaofeng Zou¹, Yuanhu Yuan¹, Hui Xu¹

Affiliations

¹ Department of Urology, First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, China.
² First Clinical Medical College, Gannan Medical University, Ganzhou, Jiangxi, China.

^# Contributed equally.

Abstract

Objectives: To present our initial experience of robotic ureteroplasty with lower-lip mucosal graft (LLMG) for treating ureteral stenosis longer than 2 cm and evaluate its feasibility and efficacy.

Materials and methods: A total of thirteen patients with ureteral stenosis who underwent robotic ureteroplasty with LLMG were retrospectively analyzed. After identification and dissection of the ureteral stenosis segment, the segment was incised longitudinally. Then, the LLMG was harvested according to the characteristics of stenosis and sutured with the ureter in onlay fashion. All procedures were completed successfully.

Result: The median stenosis length was 3.5 cm (ranged: 3.0-4.5 cm). The mean length and width of the LLMG were 3.81 ± 0.60 cm and 1.27 ± 0.26 cm, respectively. The mean operative time and anastomosis time were 212.31 ± 23.06 min and 36.54 ± 6.58 min, respectively. The double-J stent was removed at 8 weeks postoperatively in all patients. Three patients (23.1%) suffered postoperative complications during the follow-up period (range, 6-18 months), including fever, urinary tract infection and stenosis recurrence. The success rate was 92.3% (12/13).

Conclusion: Robotic ureteroplasty with LLMG is a safe and feasible technique for treating ureteral stenosis.

Keywords: lower-lip mucosa; oral mucosal graft; reconstructive surgery; robotic ureteroplasty; ureteral stenosis.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. Funding was provided by the General Project from the Health Commission of Jiangxi Province, China (No. 202210891 to Zhaolin Zhang), the Key Research and Development Plan Key Project from Department of Science and Technology in Jiangxi Province, China (No. 20212BBG71013 to Xiaofeng Zou), Key Research and Development Plan General Project from Department of Science and Technology in Jiangxi Province, China(No. 20202BBG73021 to Guoxi Zhang), the Science and Technology Innovation Talent Project from Scienceand Technology Bureau in Ganzhou, China (No. 2022CXRC9593 to Guoxi Zhang). The funders were not involved in the study design, collection, analysis, interpretation of data, the writing of this article, or the decision to submit it for publication.