医学
吻合
输尿管
外科
管腔(解剖学)
背
解剖
作者
Chaoqi Liang,Jianli Wang,Hai Bai,Yong Xu,Jinmin Zeng,Shuaishuai Chai,Jiawei Chen,Hao Zhang,Xincheng Gao,Ge Cheng,Yan Xiong,Teng Hou,Wencheng Li,Xingyuan Xiao,Bing Li
标识
DOI:10.1016/j.eururo.2022.05.006
摘要
Management of a long proximal ureteral stricture is challenging. Lingual mucosal graft ureteroplasty (LMGU) is a novel minimally invasive technique for ureteral reconstruction that avoids the morbidity of bowel interposition or autotransplantation.To evaluate the long-term effectiveness of LMGU for managing long, complex proximal ureteral strictures in a multi-institutional cohort of patients.This retrospective study involved data for 41 patients treated with LMGU at three centers between June 2015 and January 2021.LMGU was performed using either an onlay ureteroplasty in which the diseased ureter was incised ventrally and repaired with a lingual mucosal graft (LMG) to widen the ureteral lumen, or an augmented anastomotic technique in which the obliterated segment of the ureter was excised and reanastomosed primarily on dorsal side, and an LMG was placed on the ventral side.Pre-, intra-, and postoperative variables and outcomes were assessed. A descriptive statistical analysis was performed.Of 41patients, 40 were operated with laparoscopic procedures and one with a robot. Twenty-four (59%) patients underwent an onlay ureteroplasty, and 17 (41%) underwent an augmented anastomotic ureteroplasty. The reconstructed ureter was wrapped with omentum in 90% of cases. The median (range) stricture length was 4.8 cm (2.0-8.0), operative time was 166 min (98-306), and estimated blood loss was 65 ml (15-220). No open conversions and intraoperative complications occurred. At a median follow-up of 35 mo (range 13-80), the overall success rate was 97.6% (40/41).LMGU is a safe, feasible, and effective long-term technique for managing long, complex proximal ureteral strictures.We reported a novel technique for long proximal complex ureteral strictures using an onlay lingual mucosal graft (LMG). Our 6-yr outcomes demonstrate that onlay LMG ureteroplasty is a safe, feasible, and effective long-term procedure for ureteral reconstruction.
科研通智能强力驱动
Strongly Powered by AbleSci AI