Enter Note
1340 - Reconstructive Surgery for Ureteral Strictures in Renal Transplant Patients: A Comparative Analysis Between Robotic and Open Surgery
View session detail
Author Block: B. Etcheverry Giadrosich1, c. Bardella Altarriba2, M. Fiol Riera2, O. Buisan Rueda2, J. Pérez Reggeti2, J. Suárez Novo2, M. Castells Esteve3, F. Vigués Julià2, 1Urology, HospitalUuniversitari de Bellvitge, Hospitalet de Llobregat (Barcelona), Spain, 2Urology, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain, 3Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
*Purpose: Ureteral strictures are a common complication after kidney transplantation (KT) and can seriously compromise graft survival andfunction. Between 5% and 10% of KT patients develop ureteral strictures. Surgical treatment can be performed using either open orrobotic approaches. Despite the theoretical advantages of robotic surgery, comparative data remain limited. This study aims tocompare the efficacy and safety of robotic surgery versus conventional open surgery in the management of post-transplant ureteralstrictures.
*Methods: This was a single-center retrospective study of patients who underwent surgery for post-KT ureteral stricture between 2000 and2025, either by open or robotic approach. Propensity score adjustment was performed using inverse probability of treatmentweighting (IPTW). The variables analyzed included major complications (Clavien-Dindo ≥III), postoperative estimated glomerularfiltration rate (eGFR), and stricture recurrence.
*Results: A total of 90 patients were included (43 robotic surgery and 47 open surgery). After IPTW adjustment, the rate of major complicationswas significantly lower in the robotic group (9.8% vs 30.7%; p=0.03). Postoperative eGFR was comparable between groups (41.6 vs46.6 ml/min; p=0.20), and no significant differences were observed in recurrence rates (7.6% vs 12.1%; p=0.41). The presence ofmajor complications was the only significant predictor of recurrence (OR=10.4; p=0.014).Table. Comparative outcomes between open and robotic surgery
*Conclusions: Robotic surgery appears to be a safe and effective option for the treatment of post-KT ureteral strictures. Compared with opensurgery, it is associated with a lower rate of major complications while achieving equivalent functional and recurrence outcomes.These results support the progressive integration of this technique as a first-line approach in experienced centers.
| Outcome | Open (95% CI) | Robotic (95% CI) | p-value |
| Clavien ≥ III (%) | 30.7% (18.2–47.0) | 9.8% (3.5–24.5) | 0.03 |
| Recurrence (%) | 12.1% (5.2–25.5) | 7.6% (2.4–21.8) | 0.41 |
| Postoperative eGFR (ml/min) | 46.6 (41.3–52.0) | 41.6 (35.2–48.1) | 0.20 |
Postoperative creatinine (μmol/L) | 142.3 (128.0–156.6) | 170.7 (133.6–207.8) | 0.15 |