TECHNICAL FEATURES OF INTESTINAL URETEROPLASTY. PART 1: LEFT-SIDED ILEOURETEROPLASTY


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Abstract

Aim. To examine the results of intestinal ureteroplasty and present the technical features of left-sided ileoureteroplasty. Material and methods. From 2001 to 2015, 78 patients underwent isolated substitutions of the ureter using a segment of the ileum, including 57 (73.1%) one-sided and 21 (26.9%), two-sided. One patient underwent concurrent left ileoureterocystoplasty and right appendicular ureterocystoplasty. In two observations of duplicated ureter Wallace-type ileoureterocystoplasty was carried out. In total, isolated segments of the ileum were used to substitute 101 ureters. Left and right ureters were substituted in 56 (55.4%) and 45 (44.6%) patients, respectively. In 7 (8.9%) patients laparoscopic approach was used. Results. Early postoperative complications occurred in 8 (10.2%) patients and 5 (6.4%) of them required reoperation. Long-term postoperative complications occurred in 7 (8.9%) patients and 4 required surgical treatment. These patients developed strictures of ileal-ureteral anastomosis 3 and more months after surgery. Urinary tract patency was restored by antegrade stricture dilation. All patients were found to have good results of conservative treatment and repeated operations. There were no deaths. All patients achieved restoration of urodynamics and normalization of kidney function. Conclusion. Using isolated segment of the ileum allows replacing the defects of one or both ureters of any location and extent. Left-sided ileoureteroplasty is one of the most developed and simple modifications of gastrointestinal ureteral reconstructions. Isoperistaltic substitution of the left ureter is possible when the ileo-transplant is below and behind the intestinal anastomosis. The graft should be placed in isoperistaltic position and intraperitoneally, i.e. be left it in the conditions inherent in this organ.

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B. K Komyakov

Email: komyakovbk@mail.ru
I.I. Mechnikov North-Western State Medical University Multidisciplinary City Hospital №2, Department of Urology Head of Department of Urology Chief Urologist of St. Petersburg

References

  1. Kan D.V. Intestinal ureteroplasty. M.: Meditsina; 1968; 119 p. Russian (Кан Д.В. Кишечная пластика мочеточника. М.: Медицина; 1968; 119 с.).
  2. Lopatkin N.A., Shabad A.L., Achba L.N. Modern technique of intestinal substitution of ureter. Vestnik khirurgii im. I.I. Grekova. 1978; 120(2):118-124. Russian (Лопаткин Н.А., Шабад А.Л., Ачба Л.Н. Современная техника замещения мочеточника кишкой. Вестник хирург. им. И.И. Грекова. 1978;120(2):118-24).
  3. Loran O.B., Sinyakova L.A., Seregin A.V. et al. Using the isolated intestinal segments in the surgical treatment of radiation injuries of the urinary tract. Urologiia. 2012;2:20-24. Russian (Лоран О.Б., Синякова Л.А., Серегин А.В. и соавт. Использование изолированных сегментов кишечника в оперативном лечении лучевых повреждений мочевыводящих путей. Урология. 2012;2:20-24).
  4. Zuban O.N., Skornyakov S.N.,Arkanov L. V., Novikov B.I., Borodin E.P., Chotchaev R.M., Eremeev D. Yu. Surgical treatment of renal tuberculosis with a total involvement of the ureter. Urologiia. 2014;2:29- 33. Russian (Зубань О.Н., Скорняков С.Н., Арканов Л.В., Новиков Б.И., Бородин Э.П., Чотчаев Р.М., Еремеев Д.Ю. Оперативное лечение туберкулеза почки с тотальным поражением мочеточника. Урология. 2014;2:29-33).
  5. Verduyckt F., Heesakkers J., Debruyne F. Long-term results of ileal substitution. Eur. Urol. 2002;40:102.
  6. Wagner J.R., Schimpf M.O., Cohen J.L. Robot-Assisted Laparoscopic Ileal Ureter. Journal of the Society of Laparoendoscopic Surgeons 2008;12(3):306-309.
  7. Karpenko V.S. Intestinal ureteroplasty in the treatment of acquired obstructive ureterohydronephrosis. Urologiia. 2001;2:3-6. Russian (Карпенко В.С. Кишечная пластика мочеточника в лечении приобретенных обструктивных уретерогидронефрозов. Урология. 2001;2:3-6).
  8. Boxer R.J., Fritzsche P., Skinner D.G., Kaufmann J.J., Belt E., Smith R.B., Goodwin W.E. Replacement of the ureter by small intestine: clinical application and results of the ileal ureter in 89 patients. J. Urol. 1979;121:728.
  9. Armatys S.A., Mellon M.J., Beck S. D.W., Koch M.O., Foster R.S., Bihrle R. Use of Ileum as Ureteral Replacement in Urological Reconstruction. J Urol. 2009;181(1):177-181.
  10. Komyakov B.K., Guliev B.G., Novikov A.I. et al. Intestinal ureteroplasty. Urologiia. 2005;2:24-28. Russian (Комяков Б.К., Гулиев Б.Г., Новиков А.И. и соавт. Интестинальная пластика мочеточников. Урология. 2005;2:24-28).
  11. Komyakov B.K. Intestinal and appendicular ureteroplasty. M.: GEOTAR-Media. 2015. 416 s. Russian (Комяков Б.К. Кишечная и аппендикулярная пластика мочеточников. М.: ГЭОТАР-Медиа. 2015. 416 с.).
  12. Komyakov В.К., Ochelenko V.A. The long-term results of ureteral reconstruction in patients with defects of pelvic ureter. J. Urol. 2014;191(4S):e127.
  13. Küss R., Chatelain C. Surgery of the ureter. Springer-Verlag, New York, Heidlberg, Berlin. - 1975. 337 p.
  14. Kuchera Ya. Surgery of hydronephrosis and hydroureteronephrosis: Per. s cheshskogo - Praga: Gos. izd. med. lit., 1963. 221 p. Russian (Кучера Я. Хирургия гидронефроза и гидроуретеронефроза: Пер. с чешского - Прага: Гос. изд. мед. лит., 1963. 221 с.).

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