Technical features of uretral intestinoplasty. Part 3: laparoscopic ileoand appendiceal ureteroplasty

Purpose. Presentation of the results and the technical features of the laparoscopic intestinal and appendicular ureteroplasty. Materials and Methods. From 2001 to 2015, intestinal and appendicular ureteroplasty was performed in 103 patients. ileum was used for the replacement of ureteral defects in 78 (75.7%) patients, appendix - in 21 (20.4%), and colon - in 4 (3.9%). In 10 (9.7%) cases, the surgery was performed laparoscopically. Among them, 7 patients underwent ileoureteroplasty (6 - laparoscopic ileoureterocystoanastomosis, 1 - right-sided laparoscopic ileoureterocystoanastomosis by Yang-Monti) and 3 patients underwent appendiceal ureteroplasty. In one case, ileoureteroplasy was performed in patient with complete ureter duplication. Results. The period of follow-up varied from 2 to 14 years, and the average follow-up period was 8±5.8 years. Complications occurred in 8 (8.1%) patients who underwent open ileo- and appendiceal ureteroplasty. Among the 10 patients who underwent laparoscopic surgery complications were not observed. The length of postoperative hospital stay was significantly shorter in patients who underwent laparoscopic surgery (median, 6 days) than in patients who underwent open surgery (median, 12 days). The results of treatment in all patients were successful. There were no fatal outcomes. Conclusion. The use of endovideosurgery for intestinal and appendicular ureteroplasty reduces surgical injury and reduces the length of hospital stay. However, there are not enough publications on this issue available in modern literature. To date, there are few number of operations performed, and it is not allow to consider the findings and conclusions as statistically significant.

ureter, laparoscopy, intestinoplasty, appendix