ArticleBeijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences2025
[Efficacy analysis of laparoscopy combined with flexible ureteroscope in the treatment of complex ureteral stricture].
Article in Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo evaluate the safety and efficacy of a dual-endoscopic technique combining laparoscopy/robot-assisted laparoscopy with disposable flexible ureteroscopy for intraoperative localization and reconstruction in complex ureteral strictures.
methodsA retrospective analysis was conducted on 21 patients with complex ureteral strictures (stenosis length ≥2 cm, multiple strictures, or iatrogenic strictures, or radiation-induced strictures) treated at Peking University People' s Hospital between January 2023 and November 2024. All the patients underwent dual-endoscopic procedures using laparoscopy (
resultsThe cohort included 10 males and 11 females [mean age (44.1±13.3) years]. Etiologies included lithogenic strictures (71.4%, 15/21), post-gynecologic surgery injury (4.8%), radiation-induced fibrosis (4.8%), and congenital factors (19.0%). Intraoperative findings revealed discrepancies in stricture localization compared with pre-operative imaging in 52.4% (11/21) of cases, necessitating extended resection or modified reconstruction. Mean stricture length was (4.81±4.33) cm. Postoperative complications included transient urinary leakage (1 case) and secondary ureteral obstruction due to stone migration (1 case), both resolved without sequelae. At a mean follow-up of (10.76±6.81) months (range 2-21), hydronephrosis significantly improved in all the patients (100% efficacy), with no recurrence of strictures or symptom recurrence.
conclusionThe dual-endoscopic technique enhances intraoperative precision in complex ureteral stricture management by integrating real-time luminal visualization with extraluminal anatomical guidance. This approach minimizes excessive resection of healthy ureter, optimizes reconstruction strategies, and reduces postoperative recurrence. The modified positioning protocol further improves ergonomic efficiency, making it a reliable and adaptable option for challenging ureteral pathologies.
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