Abstract
You have accessJournal of UrologyTrauma/Reconstruction/Diversion: Ureter (including Pyeloplasty) and Bladder Reconstruction (including fistula), Augmentation, Substitution, Diversion II (MP53)1 Sep 2021MP53-10 INTESTINAL URETERAL RECONSTRUCTION Boris Komyakov, Viktor Ochelenko, and Bahman Guliev Boris KomyakovBoris Komyakov More articles by this author , Viktor OchelenkoViktor Ochelenko More articles by this author , and Bahman GulievBahman Guliev More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002083.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Ureteral substitution with intestinal segments remains a technique of choice in patients with extended ureteral strictures, but data about long-term results and complications of these interventions is still limited. The aim of this study is to examine the long-term efficacy and safety of these procedures on the basis of 172 ureteral substitutions with ileum, colon and appendix. METHODS: From 2001 to 2021 172 patients underwent ureteral substitution with ileum –168 (97.7%) and colon - 4 (2.3%) at our clinic. 31 (18.0%) patients underwent laparoscopic reconstruction of ureter. There were 107 (62.2%) women and 65 (37.8%) men with a median age of 54.7±9.1 years (range from 18 to 71 years). The main causes of ureteral strictures were: retroperitoneal fibrosis following radiation therapy, colorectal and gynecological cancer surgery. All patients underwent long-term follow-up including routine laboratory analysis and urinary tract imaging. Outpatient visits occurred at 3 and 6 months postoperatively and at least annually thereafter. RESULTS: The follow up period was from 3 months up to 20 years (mean 9.5±0.8 years). Postoperative complications developed in 16 (9.3%) cases. Short-term complications (less than 30 days postoperatively) occurred in 12 (6.9%) patients and included: intestinal obstruction -4 (2.3%), ileal graft mesentery thrombosis -2 (1.2%), bleeding -2 (1.2%), and acute pyelonephritis – 4 (2.3%). Late complication – stricture of uretero-ileal anastomosis developed in 4 patients (2.3%) in 3 months after operation. Thus, the complications which have required surgical treatment occurred at 12 (6.9%) patients. The results of all operations were successful. According to all patients the renal function was restored. There were no cases of metabolic acidosis. CONCLUSIONS: Intestinal ureteral reconstruction is a safe and efficacious procedures in patients with extended and multiple ureteral strictures. During long-term follow-up major complications are rare and renal function remains good. Source of Funding: no © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e942-e942 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Boris Komyakov More articles by this author Viktor Ochelenko More articles by this author Bahman Guliev More articles by this author Expand All Advertisement Loading ...
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