Laparoscopic ventral onlay ureteroplasty with buccal mucosa graft for complex proximal ureteral stricture

Abstract

Introduction: There is lack of papers dedicated to the laparoscopic buccal mucosa graft (BMG) ureteroplasty of the complex upper ureteral stricture. The aim of this study is to evaluate the results of laparoscopic BMG ureteroplasty in patients with complex proximal ureteral stricture. Material and methods: Twenty-four patients underwent laparoscopic ventral onlay BMG ureteroplasty for long or recurrent proximal ureteral stricture not amenable to uretero-ureteral anastomosis over 2019-2022. Patient demographics, operative time, estimated blood loss, length of stay, follow-up, intra- and postoperative complication rate and percentage of stricture-free at last visit were analyzed. Results: The mean stricture length was 3.6 cm. The mean operative time was 208.3 min, while mean blood loss was 75.8 mL. The length of hospital stay was 7.3 days. No intraoperative complications were observed. Postoperatively, seven patients developed complications (29.2%). Five patients experienced a Grade II (according to Clavien nomenclature). Two patients developed a Grade IIIa complication, which included leakage of the anastomosis site. The mean follow-up was on the 22 months with stricture free rate 87.5%. Conclusion: Patients with proximal ureteral strictures could be effectively treated by laparoscopic ventral onlay ureteroplasty with a buccal mucosa graft.

Pathomorphological restructuring of the buccal mucosa grafts during ureteroplasty (experimental and clinical study)

“…В настоящее время лоскут из слизистой оболочки щеки активно используют для замещения длинных стриктур уретры. Постепенно некоторые клиники набирают опыт пластики протяженных дефектов мочеточника этим трансплантатом [8][9][10][11][12][13][14]. Важное значение имеет возможность изучения приживляемости БГ, определения сроков его окончательной васкуляризации, а также патоморфологических изменений, происходящих с эпителием лоскута, который использовался для уретеропластики.…”

Laparoscopic onlay-flap ureteroplasty using cecal appendix

“…Those located at the proximal ureter can be treated by a pyeloplasty ( 4 ). The ureteric strictures in the mid-ureter are the ones that pose a greater challenge for the urologist because a ureteral substitution is needed, either using a segment of the intestine or a buccal mucosa graft ( 5 , 6 ). Our main objective is to present the management and results at 36 months of a patient with a right mid-ureter stricture.…”

International Brazilian Journal of Urology is among the Top 10 urologic journals - the new Impact Factor is 3.7!

“…Dr. Guliev and collegues from Russia performed on page 619 ( 7 ) an nice study about the laparoscopic ventral onlay ureteroplasty with buccal mucosa graft for complex proximal ureteral stricture and concluded that patients with proximal ureteral strictures could be effectively treated by laparoscopic ventral onlay ureteroplasty with a buccal mucosa graft.…”