Buccal ureteroplasty options, techniques, long-term results
Purpose of the study. Surgical treatment of extended strictures and obliterations of the ureter is still a complicated problem of modern urology. The aim of the study was to analyze our own experience of ureteral replacement plastic surgery with buccal graft, i.e buccal ureteroplasty (BU) with its e...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | Russian |
| Published: |
QUASAR, LLC
2022-06-01
|
| Series: | Исследования и практика в медицине |
| Subjects: | |
| Online Access: | https://www.rpmj.ru/rpmj/article/view/763 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1841524371097649152 |
|---|---|
| author | A. A. Volkov N. V. Budnik O. N. Zuban I. D. Mustapaev M. A. Abdulaev A. V. Muziev |
| author_facet | A. A. Volkov N. V. Budnik O. N. Zuban I. D. Mustapaev M. A. Abdulaev A. V. Muziev |
| author_sort | A. A. Volkov |
| collection | DOAJ |
| description | Purpose of the study. Surgical treatment of extended strictures and obliterations of the ureter is still a complicated problem of modern urology. The aim of the study was to analyze our own experience of ureteral replacement plastic surgery with buccal graft, i.e buccal ureteroplasty (BU) with its extended strictures/obliterations.Patients and methods. We’ve observed 25 patients who underwent BU. The lower third of the ureter was affected in 3 (12.0 %) cases, the lower third and the mouth of the ureter was affected in 7 people (28.0 %), the middle third in 2 (8.0 %), the upper third in 5 patients (20.0 %), the combined lesion of the upper third of the ureter and the pelvic‑ureteral segment (PUS) was in 8 (32.0 %) patients. All patients underwent repeated operations on a ureter, all revealed a significant comorbid background. The surgery was performed with a tubularized buccal graft in 13 (52.0 %), the onlay technique was applied in 12 (48.0 %). Laparoscopic surgery was performed in 10 (40.0 %) patients, surgical aid was carried out in an open way in 15 (60 %).Results. Severe complications according to the Clavien‑Dindo classification, requiring hospitalization of patients in the intensive care unit with organ dysfunction, as well as lethal outcomes were absent. The follow‑up period of patients ranged from 1 to 57 months (an average of 14.7 months). One patient after laparoscopic BU with a tubular graft had a short (1 mm) stenosis in the anastomosis area for 6 months of follow‑up, which was successfully eliminated by laser endoureterotomy. During the entire follow‑up period, residual hydronephrosis was recorded in 4 patients (16.0 %) against the background of complete patency of the anastomosis. A control flexible ureteroscopy performed in 16 (64.0 %) patients did not reveal rejection of the buccal graft. There are still 20 patients under our supervision.Conclusion. Our experience shows that the implementation of BU is possible on any part of the VMP using various techniques. This operation can be regarded as the "second" line of surgical treatment of strictures and obliterations of the ureter, especially after unsuccessful attempts of other reconstructions in a group of patients with severe concomitant pathology. |
| format | Article |
| id | doaj-art-a165f66905ce4f52b26e5fa1caf691c6 |
| institution | Kabale University |
| issn | 2410-1893 |
| language | Russian |
| publishDate | 2022-06-01 |
| publisher | QUASAR, LLC |
| record_format | Article |
| series | Исследования и практика в медицине |
| spelling | doaj-art-a165f66905ce4f52b26e5fa1caf691c62025-02-03T07:12:12ZrusQUASAR, LLCИсследования и практика в медицине2410-18932022-06-0192869510.17709/2410-1893-2022-9-2-7443Buccal ureteroplasty options, techniques, long-term resultsA. A. Volkov0N. V. Budnik1O. N. Zuban2I. D. Mustapaev3M. A. Abdulaev4A. V. Muziev5Hospital for War Veterans; Moscow City Scientific and Practical Center for Tuberculosis Control of the Department of Health of MoscowHospital for War VeteransMoscow City Scientific and Practical Center for Tuberculosis Control of the Department of Health of MoscowHospital for War VeteransHospital for War VeteransHospital for War VeteransPurpose of the study. Surgical treatment of extended strictures and obliterations of the ureter is still a complicated problem of modern urology. The aim of the study was to analyze our own experience of ureteral replacement plastic surgery with buccal graft, i.e buccal ureteroplasty (BU) with its extended strictures/obliterations.Patients and methods. We’ve observed 25 patients who underwent BU. The lower third of the ureter was affected in 3 (12.0 %) cases, the lower third and the mouth of the ureter was affected in 7 people (28.0 %), the middle third in 2 (8.0 %), the upper third in 5 patients (20.0 %), the combined lesion of the upper third of the ureter and the pelvic‑ureteral segment (PUS) was in 8 (32.0 %) patients. All patients underwent repeated operations on a ureter, all revealed a significant comorbid background. The surgery was performed with a tubularized buccal graft in 13 (52.0 %), the onlay technique was applied in 12 (48.0 %). Laparoscopic surgery was performed in 10 (40.0 %) patients, surgical aid was carried out in an open way in 15 (60 %).Results. Severe complications according to the Clavien‑Dindo classification, requiring hospitalization of patients in the intensive care unit with organ dysfunction, as well as lethal outcomes were absent. The follow‑up period of patients ranged from 1 to 57 months (an average of 14.7 months). One patient after laparoscopic BU with a tubular graft had a short (1 mm) stenosis in the anastomosis area for 6 months of follow‑up, which was successfully eliminated by laser endoureterotomy. During the entire follow‑up period, residual hydronephrosis was recorded in 4 patients (16.0 %) against the background of complete patency of the anastomosis. A control flexible ureteroscopy performed in 16 (64.0 %) patients did not reveal rejection of the buccal graft. There are still 20 patients under our supervision.Conclusion. Our experience shows that the implementation of BU is possible on any part of the VMP using various techniques. This operation can be regarded as the "second" line of surgical treatment of strictures and obliterations of the ureter, especially after unsuccessful attempts of other reconstructions in a group of patients with severe concomitant pathology.https://www.rpmj.ru/rpmj/article/view/763buccal ureteroplastybuccal graftureteral strictureureteral obliterationlaparoscopic ureteroplasty |
| spellingShingle | A. A. Volkov N. V. Budnik O. N. Zuban I. D. Mustapaev M. A. Abdulaev A. V. Muziev Buccal ureteroplasty options, techniques, long-term results Исследования и практика в медицине buccal ureteroplasty buccal graft ureteral stricture ureteral obliteration laparoscopic ureteroplasty |
| title | Buccal ureteroplasty options, techniques, long-term results |
| title_full | Buccal ureteroplasty options, techniques, long-term results |
| title_fullStr | Buccal ureteroplasty options, techniques, long-term results |
| title_full_unstemmed | Buccal ureteroplasty options, techniques, long-term results |
| title_short | Buccal ureteroplasty options, techniques, long-term results |
| title_sort | buccal ureteroplasty options techniques long term results |
| topic | buccal ureteroplasty buccal graft ureteral stricture ureteral obliteration laparoscopic ureteroplasty |
| url | https://www.rpmj.ru/rpmj/article/view/763 |
| work_keys_str_mv | AT aavolkov buccalureteroplastyoptionstechniqueslongtermresults AT nvbudnik buccalureteroplastyoptionstechniqueslongtermresults AT onzuban buccalureteroplastyoptionstechniqueslongtermresults AT idmustapaev buccalureteroplastyoptionstechniqueslongtermresults AT maabdulaev buccalureteroplastyoptionstechniqueslongtermresults AT avmuziev buccalureteroplastyoptionstechniqueslongtermresults |