Laparoscopic ureteral replacement by Boari flap: Multi-institutional experience in 30 cases

Abstract

IntroductionThe Boari flap is an excellent technique for replacement of distal ureteral injuries. There are few reports with the use of laparoscopic surgery, especially with long term results. Our goal is to present the results of a multi-institutional study of 30 cases. Materials and methodsWe analyzed 30 patients treated between December 2001 and January 2009 who underwent a laparoscopic intracorporeal Boari flap, in three Latin American centers. In all cases the same surgical technique was employed. The database was recorded prospectively and analyzed retrospectively. ResultsThe mean age was 43.2 years (range 9–71 years). Most were women (22 of 30) with a slight predominance of left-side lesions (17 of 30). The most common cause of ureteral injury was hysterectomy in 14 patients (46.6%) and endoscopic ureterolithotomy in 9 patients (30%). The mean length of ureteral resection was 7cm (5–20cm). The average operative time was 161.16min (90–280min). The average estimated blood loss was 123mL (0–500mL), and hospital stay was 4.86 days (2–10 days). There were no intraoperative complications or conversion to open surgery. Postoperative complications occurred in 5 patients (16.6%), Clavien 1 in 2 patients (6.6%) and Clavien 3 in three patients (10%). The success rate was 96.6% (29 patients) with a mean follow up of 32 months (5–60 months). ConclusionsLaparoscopic Boari flap in our hands had good short and long term results.