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A Murine Model of Irreversible and Reversible Unilateral Ureteric Obstruction
Published on: December 20, 2014
[Technical features of intestinal ureteroplasty. Part 2: right-sided ileoureteroplasty]
B K Komyakov1,2, B G Guliev1,2, V A Ochelenko1,2
1Department of Urology, I.I. Mechnikov North-Western State Medical University.
Aim:
To present the results of intestinal ureteroplasty and technical features of right-sided ileoureteroplasty.
Material And Methods:
From 2001 to 2015, 78 patients underwent isolated reconstruction of the ureter using a segment of the ileum, of whom 57 (73%) and 21 (27%) patients had unilateral and bilateral operation, respectively. In total, isolated segments of the ileum were used to substitute 101 ureters including 45 (44.6%) right ureters.
Results:
The follow-up period ranged from 3 months to 14 years (mean 8.3 +/- 0.8 years). Early postoperative complications occurred in 8 (10.2%) patients and 5 (6.4%) of them required reoperation. Long-term postoperative complications occurred in 7 (8.9%) patients and 4 required surgical treatment. All patients had good results of conservative treatment and reoperations. There were no deaths. All patients achieved restoration of urodynamics and normalization of kidney function.
Conclusion:
Right-sided, especially total, ileoureteroplasty is the most technically challenging among other possible options to substitute the ureter with a small bowel segment. To avoid mesenteric torsion when performing isoperistaltic ureteroplasty, the graft should be placed above and in front of the intestinal anastomosis.
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