Reconfigured colon segments as a ureteral substitute.

Abstract

Reconfigured colon was used as a ureteral substitute in seven selected patients. In four patients, a single reconfigured colon segment was interposed into an extensive defect of the upper ureter. In an additional three patients with solitary kidney, reconfigured colon segments were used for the construction of a conduit. At a mean follow-up of 23 months (range: 2-38 months), no complications related to the reconfigured colon segments were noted. Two patients died of progressive disease, but with no evidence of malfunction of the ureteral substitute. Surgical access is mainly retroperitoneal, and intraperitoneal surgery is minimal. The colonic segments are taken immediately proximal to the ureteral defect, necessitating little mobilization of the mesenteric pedicle. In patients with renal insufficiency or a history of irradiation, this technique may be superior to the use of ileum. Before wider use, long term follow-up data on the uretero-intestinal anastomosis will be necessary.