Successful Multidisciplinary Repair of Severe Bilateral Uretero-Enteric Stricture with Inflammatory Reaction Extending to the Left Iliac Artery, after Robotic Radical Cystectomy and Intracorporeal Ileal Neobladder
, Alex Anh Ly Nguyen 1,2, Alessandra Taverna 1,2, Paolo Beltrami 1,2, Filiberto Zattoni 1,2 and Fabrizio Dal Moro 1,2
Tom J. H. Arends
Round 1
Reviewer 1 Report
this is a good representation of a challenging case report concerning bilateral ureter stenosis.
few questions/ suggestions:
the interposition of a Casati-Boari flap, harvested for the VIP. --> is "harvested from the VIP" not better???
"bilateral percutaneous nephrostomies were positioned", please describe when these were taken out. and why did you not first retract the MJ-stents, whit nephrostomies in situ but closed. then an X-APG to check the anastamoses, then (when kidney function was stable after 7 days with closed nephrostomies in stu) removed the nephrostomies.
in short: please describe what you did with the bilateral preoperative placed nephrostomies.
Author Response
Please see the attchment
Author Response File: 
Author Response.docx
Reviewer 2 Report
The aim of the manuscript was to describe a case report of successful correction of bilateral uretero-enteric stricture following RARC with intracorporeal ileal neobladder. Unfortunately, I did not find any novelty, in terms of case, surgical treatment or postoperative management. The case report is a well known case of uretero-eneteric stricture, which required a traditional surgical approach. Moreover, there are several critical aspects that Authors need to review in order to improve overall quality of manuscript.
- Title is too long and it does not sound attractive
- Authors need to report feasibility of robotic approach to perform ureteral reimplantation (Transnephrostomic Indocyanine Green-Guided Robotic Ureteral Reimplantation for Benign Ureteroileal Strictures After Robotic Cystectomy and Intracorporeal Neobladder: Step-By-Step Surgical Technique, Perioperative and Functional Outcomes - J Endourol. 2019 Oct;33(10):823-828. doi: 10.1089/end.2019.0376. Epub 2019 Sep 26.)
- Figures must be improved, they appear to much easy...
- Preoperative CT-urography are not clear. Probably, Authors need to report better CT-scan images, and they have to improve images reporting length of stricture.
- Pathologic TNM stage after RARC must be included in the report.
- Functional baseline and postoperative outcomes must be included, in order to evaluate efficency of surgical treatment.
Author Response
Thank you for your comments. Please see the attachment
Author Response File: Author Response.docx
Round 2
Reviewer 2 Report
Authors properly addressed reviewer comments. However, there are a few critical aspects that authors needs to review in order to improve overall quality of manuscript. Authors needs to report functional outcomes after surgery (kidney function, urinary continence status). Moreover, table reporting perioperative outcomes must be included.
Author Response
Please see the attachment
Author Response File: Author Response.docx
Round 3
Reviewer 2 Report
No major comments
