Buccal mucosal ureteroplasty for the management of ureteric strictures: A systematic review of the literature

Abstract

Objective To review the published literature evaluating the efficacy and safety of buccal mucosa ureteroplasty. Methods A systematic literature review was carried out using a protocol devised a priori. The review was registered with the Joanna Briggs Institute. Results were scrutinized and full text of all relevant articles was obtained for review. Results A systematic search resulted in 1092 articles, with scrutiny resulting in 1079 exclusions. Two additional articles were identified from references, resulting in a total of 15 included studies containing a total of 72 buccal mucosal ureteroplasty procedures. A total of 34 cases were carried out using the open approach, and 38 were carried out using the robot assisted approach. The overall reported success rate was reported to be 66 out of 72 (91.6%), being 32 out of 34 (94.1%) and 34 out of 38 (89.5%) open and robotic cases, respectively. The complication rate was reported in 60 cases, being 15 out of 60 (25%) for all complications, with a 5% (3/60) rate for complications graded as Clavien–Dindo score ≥3. Conclusions Buccal mucosa ureteroplasty appears to have high success rates and low rates of serious complications in both open and robot assisted approaches. However, the current available literature is limited to 72 cases, and further studies with larger patient populations and ongoing longitudinal review are warranted.

Buccal Mucosal Ureteroplasty for the Management of Ureteral Strictures: Patient Selection and Considerations

“…Use of an omental wrap has been most commonly described, and perirenal fat has also been utilized to provide a vascular bed for the graft with good success if omentum is not accessible. 13 , 32 In Kroepfl’s cohort, 4 of 7 ureteral strictures were post-radiation, 2 had previously failed end-to-end anastomosis, and 1 was secondary to open pyelolithotomy. 10 In Zhao’s multi-institutional study, 53% of patients had undergone a prior failed ureteral reconstruction.…”

Oral mucosa as graft material for the purposes of reconstructive urology

“…Using oral mucosa as graft material in reconstructive surgery of the ureter has been gaining popularity 37,38 because of the high risk of complications associated with using an intestinal segment or auto transplantation.…”

Ureteroplasty using oral mucosa graft: a literature review. Update in 2022

“…Варианты долгосрочной реконструкции, такие как интерпозиция подвздошной кишки или отведение мочи путём уретерокутанеостомии, сопряжены с развитием метаболических нарушений и других побочных эффектов, поэтому не могут быть использованы у всех пациентов [4]. Аутотрансплантацию почки рассматривают в случаях неэффективности других подходов и важности сохранения функции почки, а крайней мерой, когда другие варианты не подходят, служит нефрэктомия [5].…”