USE OF BUCCAL GRAFT FOR THE MANAGEMENT OF URETERAL STRICTURES


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Abstract

This review analyses of the results of using buccal mucosa graft for the management of ureteral strictures. The authors identified sixteen original studies presenting the results of ureteral reconstruction using buccal grafts. Of them, twelve, three and one studies used the open, robotic and laparoscopic technique, respectively. Open surgery was performed 44 times in 42 patients (2 patients underwent bilateral ureteroplasty) with an average ureteral stricture length of 6.0 (2.5-11) cm. Ureteral patency was restored in 93.2% (41/44) of patients with an average follow-up of 26 (3-85) months. The robotic technique was used in 18 patients with an average ureteral stricture length of 3.25 (1.5-6) cm. Positive results after similar operations were achieved in 88.9% (16/18) of patients with an average follow-up of 15 (4-30) months. The laparoscopic technique was used only once for a ureteral stricture measuring 3 cm in length and was characterized as successful at a follow-up of 9 months. All surgical modalities were associated with minimal risk of early and late postoperative complications. The review results suggest that buccal substitution ureteroplasty can be regarded as an advantageous alternative to more complicated surgical procedures associated with greater complication rates (ileal ureteral substitution and kidney autotransplantation) used for long ureteral strictures.

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About the authors

M. I Katibov

N.A. Lopatkin Scientific Research Institute of Urology and Interventional Radiology - branch of the NMRRC of Minzdrav of Russia

Email: mikatibov@mail.ru
Dr.Med.Sci.,Chief Researcher Moscow, Russia

N. V Polyakov

N.A. Lopatkin Scientific Research Institute of Urology and Interventional Radiology - branch of the NMRRC of Minzdrav of Russia

Email: nikp73@bk.ru
Ph.D., Senior Researcher Moscow, Russia

N. G Keshishev

N.A. Lopatkin Scientific Research Institute of Urology and Interventional Radiology - branch of the NMRRC of Minzdrav of Russia

Email: nkeshishev@gmail.com
Ph.D., Head of Department Moscow, Russia

O. I Apolikhin

N.A. Lopatkin Scientific Research Institute of Urology and Interventional Radiology - branch of the NMRRC of Minzdrav of Russia

Email: apolikhin.oleg@gmail.com
Dr.Med.Sci, Prof., Director Moscow, Russia

A. D Kaprin

NMRRC of Minzdrav of Russia

Email: kaprin@mail.ru
Academician of the RAS, Dr.Med.Sci., Professor, Director General Moscow, Russia

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