[Ureteral realignment with the rendezvous procedure in complex ureteral injuries - aspects of technique and our
Alexander Sascha Brandt1, F-C von Rundstedt, D A Lazica
1Klinik für Urologie und Kinderurologie, Helios Klinikum Wuppertal, Lehrstuhl der Universität Witten / Herdecke, Wuppertal. alexander-sascha.brandt@helios-kliniken.de
Purpose:
The rendezvous procedure for re-establishing ureteral continuity after complex ureteral injuries is introduced and we present our experience with this technique.
Material And Methods:
Aspects of the technique are described in a detailed step-by-step instruction using intraoperative radiographs. We evaluated our patient data from 1998 until 2009 for cases in which the rendezvous procedure was attempted.
Results:
The rendezvous procedure was used in a total of 11 patients. Realignment was successful in 10 cases (90.9 %) and the initial nephrostomy could be removed. In 3 of 7 cases postoperative removal of the JJ ureteric stent was successful. In 7 patients the final surgical ureter reconstruction was performed after a medium period of 7 months. 5 cases of ureteroneocystostomy and 2 cases of reconstruction of the ureter either with colon or ileum segments were accomplished. In 1 patient a permanent maintenance of the DJ ureteral stent was necessary.
Conclusion:
Ureteral realignment with the rendezvous procedure enables disposition of the ureteral stent in many cases, exclusively antegrade or retrograde procedures failed. By this means nephrostomy could be spared as a temporary or permanent solution and a better chance of restitutio ad integrum could be realised.
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Ureters
