V01-07 DECISION POINT FOR BUCCAL MUCOSA GRAFT URETEROPLASTY: AUGMENTED ANASTOMOTIC VERSUS VENTRAL ONLAY TECHNIQUE

Abstract

You have accessJournal of UrologyCME1 Apr 2023V01-07 DECISION POINT FOR BUCCAL MUCOSA GRAFT URETEROPLASTY: AUGMENTED ANASTOMOTIC VERSUS VENTRAL ONLAY TECHNIQUE Matthew Lee, David Strauss, Julienne Jeong, Jeffrey Wei, Joshua Kim, Ziho Lee, Lee Zhao, Michael Stifelman, and Daniel Eun Matthew LeeMatthew Lee More articles by this author , David StraussDavid Strauss More articles by this author , Julienne JeongJulienne Jeong More articles by this author , Jeffrey WeiJeffrey Wei More articles by this author , Joshua KimJoshua Kim More articles by this author , Ziho LeeZiho Lee More articles by this author , Lee ZhaoLee Zhao More articles by this author , Michael StifelmanMichael Stifelman More articles by this author , and Daniel EunDaniel Eun More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003221.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The two main approaches utilized in buccal mucosa graft ureteroplasty for surgical management of ureteral strictures include the onlay and augmented anastomotic techniques. We describe the decision-making process and surgical technique for each approach. METHODS: We demonstrate the case of a patient with bilateral ureteral strictures who underwent multiple prior ureteroscopic stone procedures and a failed left dismembered pyeloplasty. The patient underwent an augmented anastomotic buccal mucosa graft ureteroplasty for a right sided obliterated stricture and an onlay buccal mucosa graft ureteroplasty for a left sided narrowed stricture. Table 1 demonstrates perioperative data from the Collaborative of Reconstructive Robotic Ureteral Stricture database for each technique. RESULTS: The surgical technique utilized for buccal mucosa graft ureteroplasty depends on stricture quality, which include narrowed versus obliterated characteristics. An onlay technique is the preferred approach for narrowed strictures, while an augmented anastomotic technique is the preferred approach for obliterated strictures. Surgical success was demonstrated in 92.3% and 84.6% of patients undergoing an onlay versus augmented anastomotic technique, respectively. CONCLUSIONS: In patients undergoing buccal mucosa graft ureteroplasty, stricture quality is an important factor involved in the decision-making process when choosing to perform an onlay versus augmented anastomotic approach. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e81 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Matthew Lee More articles by this author David Strauss More articles by this author Julienne Jeong More articles by this author Jeffrey Wei More articles by this author Joshua Kim More articles by this author Ziho Lee More articles by this author Lee Zhao More articles by this author Michael Stifelman More articles by this author Daniel Eun More articles by this author Expand All Advertisement PDF downloadLoading ...