Transabdominal Laparoscopic Ureteroureterostomy With the Intraoperative Retrograde Ureteroscopy-Assisted Technique for Multiple Ureteral Polyps: A Single-Center 10 Years Experiences.

Weiping Xia,Zhi Chen,Kangning Wang,Yao He,Bingsheng Li,Jin Long,Yang Li,Zexiang Jiang,Yu Gan,Zewu Zhu,Xiang Chen,Hequn Chen,Bo Zhang

doi:10.3389/fsurg.2022.814290

Abstract

BackgroundThe purpose of this study was to report our experience in treating multiple ureteral polyps with transabdominal laparoscopic ureteroureterostomy (LAP-UU) with intraoperative retrograde ureteroscopy (RU)-assisted technique.MethodsThe data of 32 patients who underwent transabdominal LAP-UU with the intraoperative RU-assisted technique due to multiple ureteral polyps between January 2011 and March 2021 were reviewed at our institute. After administration of anesthesia, patients were placed in a passive position and underwent a three-port transabdominal laparoscopy with RU. Detailed data were reviewed, such as demographic characteristics, intraoperative outcomes, postoperative data, complications, and pathology reports.ResultsThirty-two patients were diagnosed with multiple ureteral polyps underwent this surgery method at our institution. The mean duration of symptoms at the time of diagnosis was approximately 7.1 months. The mean age of patients was 42.4 years, with men accounting for 68.8% (22/32), lesion of left for 56.3% (18/32), and the upper ureter for 62.5% (20/32). Furthermore, the median length of the polyps was 3.6 cm, the mean operative time was 174.6 min, and the estimated blood loss (EBL) was about 86.8 ml. The mean time to begin a liquid diet and to be out of bed were 1.7 and 2.3 days, respectively. The average length of hospital stay was 6.3 days. The ureteral stent was removed by cystoscope 2–3 months after surgery. Follow-up duration ranged from 3 to 112 months and none of the patients required another surgery for recurrence.ConclusionTransabdominal LAP-UU combined with the intraoperative RU-assisted technique is an effective, safe, and reliable surgical option for patients with multiple ureteral polyps. Further long-term follow-up is recommended.

Highlights

Ureteral polyps are rare benign tumors originating from the ureteral epithelium or non-epithelium that can cause intrinsic ureteral obstruction and related symptoms
We describe our surgical technique in detail and present our experience with this surgical technique for the treatment of ureteral obstruction caused by multiple ureteral polyps
Multiple ureteral polyps were most found on the left (56.3%, 18/32) than on the right (43.7%, 14/32) and were more commonly located in the upper ureter (62.5%, 20/32) than in the middle ureter (15.6%, 5/32) or lower ureter (21.9%, 7/32) in patients, respectively

Summary

Introduction

Ureteral polyps are rare benign tumors originating from the ureteral epithelium or non-epithelium that can cause intrinsic ureteral obstruction and related symptoms. The transabdominal laparoscopic ureteroureterostomy (LAP-UU) technique has been reported as a minimally invasive surgical approach for the treatment of ureteral obstruction resulting from ureteral polyps [8, 9]. In this procedure, the surgeon often has to blindly open the ureter intraoperatively, which can lead to the ureter opening in the wrong position, a long segment of the ureter being removed, or incomplete resection of polyps. The purpose of this study was to report our experience in treating multiple ureteral polyps with transabdominal laparoscopic ureteroureterostomy (LAP-UU) with intraoperative retrograde ureteroscopy (RU)-assisted technique

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