Laparoscopic ileal ureteral substitution. Results of the first 40 operations


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Abstract

Introduction. Despite the twenty-year history of laparoscopic ileal ureteral substitution, the literature is lacking studies reporting its outcomes, and those few are mainly case reports. Besides, they usually describe surgery from combined access, when the ileal segment resection and ileo-ileal anastomosis are performed from mini-laparotomy, and the remaining stages are done endoscopically. Aim. To conduct a multicenter retrospective analysis of our series of patients undergoing laparoscopic ileal ureteral substitution using only endoscopic access. Material and methods. From 2010 to 2017, 48 ureters were replaced completely laparoscopically in 40 patients. Ofthem, 33 patients underwent total ureteric replacement, and the others had a subtotal ileal ureteral substitution. Video describing the operation technique is available on https://youtu.be/IeA60pSiUBE. Results. The mean operating time was 335 minutes, and the estimated blood loss was 221 ml. Intraoperative complications (7.5%) were resolved during surgery. No patients required conversion to open surgery. There was no mortality. Postoperative Clavien III complications were observed in 7.5% of patients. The mean length of hospital day was 13.5 days. Functional results were followed from 6 months to 7 years. Conclusions. The presented material is the largest available in the literature, and the results, including long-term functional outcomes, demonstrate the efficacy and safety of laparoscopic technologies in the treatment of extensive strictures and obliterations of the ureter.

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About the authors

A. D Kochkin

PRMU of Minzdrav of Russia; Clinical Hospital at Nizhny Novgorod Railway Station of JSC «RZD»

Email: kochman@bk.ru
Ph.D., Teaching Assistant at the E.V. Shakhov Department of Urology; Urologist at the Department of Urology

E. A Gallyamov

I.M. Sechenov First MSMU of Minzdrav of Russia (Sechenov University)

Email: gal_svetlana@mail.ru
Dr.Med.Sci., Head of the Department of General Surgery, Faculty of Medicine

S. V Popov

St. Luke’s Clinical Hospital; I.I. Mechnikov North-Western State Medical University

Email: doc.popov@gmail.com
Dr.Med.Sci Chief Physician of; Associate Prof. at the Department of Urology

R. G Biktimirov

IPPE of A.I. Burnazyan FMBC, FMBA of Russia; Federal Clinical Center for HMT

Email: rafbik@kb119.ru
Ph.D., Associate Professor at the Department of Urology and Andrology; Head of the Department of Urology

A. E Sanzharov

Federal Scientific and Clinical Center, FMBA of Russia

Email: sanzh@mail.ru
Head of the Department of Urology

V. P Sergeev

A.I. Burnazyan SRC FMBC, FMBA of Russia

Email: garivas@yandex.ru
Head of the Department of Urologic Oncology

F. A Sevryukov

PRMU of Minzdrav of Russia; Clinical Hospital at Nizhny Novgorod Railway Station of JSC «RZD»

Email: fedor_sevrukov@mail.ru
Dr.Med.Sci., Associate Prof., Prof. at the E.V. Shakhov Department of Urology; Head of the Department of Urology

I. N Orlov

St. Luke’s Clinical Hospital

Email: doc.orlov@gmail.com
Ph.D., Head of Department of Urology

A. B Novikov

Multidisciplinary Medical Center of the Bank of Russia

Email: novikov-ab@yandex.ru
Head of the Department of Urology

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