title: Ureteroenteric anastomotic revision as initial management of stricture after urinary diversion.
abstract: To report our experience with ureteroenteric anastomotic revision as initial treatment of stricture after urinary diversion.
  
  
  
  An institutional review board-approved retrospective study was carried out. A total of 41 patients who underwent primary ureteroenteric anastamotic revision were identified between 2007 and 2015. Data analyzed included patient characteristics, type of diversion, estimated blood loss, operative time, change in renal function, length of stay, postoperative complications and time with nephrostomy/stent. Success of revision was defined as an improvement in hydronephrosis on radiographic imaging and/or reflux during pouchogram. Predictors of length of stay and complications were analyzed using analysis of covariance.
  
  
  
  A total of 50 renal units were revised with a success rate of 100%. The median length of stay was 6 days (2-16 days). There were a total of 15 complications (one major, 14 minor) in 14 patients (33% 30-day complication rate). The most common were wound infection (n = 4) and arrhythmia (n = 4). Robotic revision (n = 5) had a median length of stay of 3 days (2-4) with no complications.
  
  
  
  Primary ureteroenteric anastomotic revisions have an excellent success rate at an experienced center and might obviate the need for multiple interventions. Open revision is associated with mostly minor complications. Robotic revision might reduce the morbidity of open revision in select cases.
authors.affiliation: Division of Urology and Urologic Oncology, City of Hope National Medical Center, Duarte, California, USA.
authors.forename: Greg E
authors.initials: GE
authors.lastname: Gin
authors.affiliation: Division of Biostatistics, City of Hope National Medical Center, Duarte, California, USA.
authors.forename: Nora H
authors.initials: NH
authors.lastname: Ruel
authors.affiliation: Division of Urology and Urologic Oncology, City of Hope National Medical Center, Duarte, California, USA.
authors.forename: Jaspreet S
authors.initials: JS
authors.lastname: Parihar
authors.affiliation: Division of Urology and Urologic Oncology, City of Hope National Medical Center, Duarte, California, USA.
authors.forename: Jonathan N
authors.initials: JN
authors.lastname: Warner
authors.affiliation: Division of Urology and Urologic Oncology, City of Hope National Medical Center, Duarte, California, USA.
authors.forename: Bertram E
authors.initials: BE
authors.lastname: Yuh
authors.affiliation: Division of Urology and Urologic Oncology, City of Hope National Medical Center, Duarte, California, USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Yamzon
authors.affiliation: Division of Urologic Oncology, Providence St. John's Health Center, Santa Monica, California, USA.
authors.forename: Timothy G
authors.initials: TG
authors.lastname: Wilson
authors.affiliation: Division of Urology and Urologic Oncology, City of Hope National Medical Center, Duarte, California, USA.
authors.forename: Clayton S
authors.initials: CS
authors.lastname: Lau
authors.affiliation: Division of Urology and Urologic Oncology, City of Hope National Medical Center, Duarte, California, USA.
authors.forename: Kevin G
authors.initials: KG
authors.lastname: Chan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000009:adverse effects; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology / Q000601:surgery; D015653:Cystectomy / Q000009:adverse effects / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006869:Hydronephrosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology / Q000601:surgery; D007422:Intestines / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology / Q000601:surgery*; D012086:Reoperation / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014513:Ureter / Q000473:pathology / Q000601:surgery; D014517:Ureteral Obstruction / Q000453:epidemiology / Q000209:etiology / Q000601:surgery*; D001749:Urinary Bladder Neoplasms / Q000601:surgery; D014547:Urinary Diversion / Q000009:adverse effects* / Q000379:methods
keywords: anastomosis; complications; outcomes; stricture; urinary diversion