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Reconfigured colon segments as a ureteral substitute
1Department of Adult and Pediatric Urology, Helios Klinikum Wuppertal, Witten/Herdecke University, Heusnerstrasse 40, 42283 Wuppertal, Germany. b.ubrig@klinikum-wuppertal.de
World Journal of Urology
|August 28, 2003
Summary
Reconfigured colon segments show promise as ureteral substitutes, with no complications observed in seven patients. This technique may offer advantages over ileum for patients with renal insufficiency or prior irradiation.
Area of Science:
- Urology
- Gastroenterology
- Surgical Innovation
Background:
- Ureteral defects pose reconstructive challenges.
- Ileum is a common substitute, but has limitations.
- Alternative materials are being explored for ureteral substitution.
Purpose of the Study:
- To evaluate the efficacy and safety of reconfigured colon segments as ureteral substitutes.
- To assess the outcomes in patients with extensive upper ureteral defects and those requiring conduit construction for solitary kidneys.
Main Methods:
- Seven patients underwent ureteral substitution using reconfigured colon segments.
- Four patients received interposition for upper ureteral defects.
- Three patients with solitary kidneys utilized colon segments for conduit construction.
Main Results:
- A mean follow-up of 23 months revealed no complications related to the colon segments.
- Two patients died from unrelated progressive disease, without ureteral substitute malfunction.
- The surgical approach was primarily retroperitoneal with minimal intraperitoneal exposure.
Conclusions:
- Reconfigured colon segments appear to be a safe and effective option for ureteral substitution.
- This technique may be particularly beneficial for patients with renal insufficiency or a history of irradiation.
- Further long-term studies on uretero-intestinal anastomosis are warranted before widespread adoption.