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Published on: April 28, 2023
943
Augmented anastomotic ureteral reconstruction using buccal mucosal graft, initial experience
Ahmed M Reyad1, Ahmed Mamdouh Abd Elhamed1, Ahmed Mahmoud Elsherief1
1Faculty of medicine, Sohag University, Sohag, Egypt.
Urologia
|March 28, 2024
Summary
Augmented ureteral reconstruction using buccal mucosal grafts on omental flaps shows promising results for ureteral strictures. This technique facilitates better anatomical reconstruction and successful tissue integration.
Area of Science:
- Urology
- Surgical Innovation
- Regenerative Medicine
Background:
- Ureteral strictures pose significant challenges in reconstructive urology.
- Traditional repair methods can be limited by graft availability and complex surgical techniques.
Purpose of the Study:
- To evaluate the efficacy of augmented anastomotic ureteral reconstruction using buccal mucosal grafts supported by omental flaps.
- To assess the feasibility and outcomes of this technique in managing various ureteral strictures.
Main Methods:
- A prospective cohort study involving 13 patients with upper and mid ureteral strictures.
- Buccal mucosal patch grafts were fixed to omental flaps before anastomosis to ureteral walls.
- Patients underwent comprehensive clinical and laboratory assessments, including renal function tests and diuretic renography.
Main Results:
- Mean operative time was 148.85 minutes, with a mean hospital stay of 3 days.
- Mean follow-up was 13 months, with most patients showing non-obstructive renal function (RI < 0.7).
- One patient required nephrostomy due to severe postoperative UTI.
Conclusions:
- Buccal mucosal graft ureteroplasty, augmented with omental flaps, is a viable option for selected patients.
- Fixing the graft to the omentum ensures stable anatomical reconstruction and prevents pedicle twisting.
