Laparoscopy-Assisted Ileal Ureter Creation for Multiple Tuberculous Strictures: Report of Two Cases

Abstract

We describe in detail the technique of laparoscopy-assisted ileal ureter creation for multiple tuberculous ureteral strictures in two patients. The proximal anastomosis included an ileocalicostomy in the first patient and an ileopyelostomy in the second patient. The first patient had bowel entrapment behind the mesentery of the ileal loop, but the second patient had an uneventful postoperative recovery. Short-term follow-up showed good patency of the ileal loop. The variations in the technique that can cause postoperative problems are discussed, and the future of this technique is postulated.

Laparoscopic ureterolysis with simultaneous ureteroscopy and percutaneous nephroscopy for treating complex ureteral obstruction after failed endoscopic intervention: A technical report

“…Laparoscopic ureterolysis was reported to achieve a success rate of nearly 100% over a 1-year follow-up period [15] , which has been arousing great enthusiasm and growing interest in laparoscopic intervention for treating ureteral obstruction. Minimally invasive laparoscopic ureteroureterostomy and ureteral reimplantation with endoureterotomy have replaced open surgery as the standard of care for ureteral obstruction, even in complex cases [16] . However, in case of more complicated ureteral obstruction, laparoscopic only approach may not guarantee the success of procedure, so simultaneously combined retrograde ureteroscopic with or without antegrade nephroscopic approach can be an option in this case.…”

Sustitución ureteral bilateral con asa ileal

“…El intestino delgado es el segmento más utilizado, sin embargo, se han descrito experiencias con colon 10 . La seguridad del uréter ileal ha sido validada en grandes series y recientemente en procedimientos laparoscópicos 11,12 . Las contraindicaciones absolutas son enfermedad infl amatoria intestinal, insufi ciencia renal e insufi ciencia hepática severas 7 .…”

Laparoscopic bowel ureteroplasty

“…больных в стационаре и их реабилитации [6][7][8]11]. Недавние работы показали возможность полного интракорпорального замещения мочеточника тон-кой кишкой [5,6,9].…”

“…В этих случаях даже при открытом доступе встре-чаются технические сложности по выделению ки-шечника из спаек, его резекции и формированию анастомозов. Показанием к лапароскопической илеоуретеропластике в большинстве случаев были травмы мочеточников во время эндоскопических и гинекологических вмешательств, постлучевые и туберкулезной этиологии стриктуры мочеточника, его дефект после резекции по поводу опухоли [1,2,11,12]. У этих больных ввиду отсутствия спаечной болезни целесообразно выполнить кишечную пла-стику лапароскопическим доступом.…”