Left ureteral appendiceal interposition: Exercise caution and do not be mislead by postoperative radiological obstruction

Filho, Aderivaldo Cabral Dias; Martinez, Carlos Alberto Toledo; Côrte, Maria Bianca; Maroccolo, Marcus Vinícius Osorio

doi:10.1590/s1677-5538.ibju.2017.0295

Cited by 4 publications

(2 citation statements)

References 7 publications

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“…Some case reports and case series reports (as shown in Table 2) of appendiceal interposition were reported during the past century, as some technical issues might limit the use of the appendix. [49][50][51][52][53] The appendix could be unavailable or unsuitable for ureteral reconstruction when it is absent because of previous appendectomy, or it became scarred or narrow as a result of previous inflammation. The length of the appendix is finite, replacing approximately 3-cm ureteral defects on average, and usually it fails to bridge long-segment strictures or a defect is left-sided.…”

Section: Appendiceal Interpositionmentioning

confidence: 99%

“…The small luminal diameter of the appendix restricts the tendency to dilate with the passage of time, and together its intrinsic peristalsis leads to a minimal risk of urinary stasis and reflux. Some case reports and case series reports (as shown in Table 2) of appendiceal interposition were reported during the past century, as some technical issues might limit the use of the appendix . The appendix could be unavailable or unsuitable for ureteral reconstruction when it is absent because of previous appendectomy, or it became scarred or narrow as a result of previous inflammation.…”

Section: Appendiceal Interpositionmentioning

confidence: 99%

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Intestinal interposition for complex ureteral reconstruction: A comprehensive review

Xiong

Zhu

et al. 2020

Int J of Urology

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Long ureteral defects have remained a challenge to urologists for a long time. Bowel interposition, including ileal ureter, appendiceal interposition and reconfigured colon substitution, has gained wide acceptance, even though it is a complicated procedure and associated with some potential complications. Mucus obstruction and metabolic disorders are common complications of intestinal substitution. To circumvent these troubles, modified techniques, such as tapering the bowel graft, intestinal onlay flap and the Yang-Monti procedure, are used. In particular, Yang-Monti ileal ureter replacement is a highly effective option for ureteral reconstruction, and the incidence of complications would be significantly reduced in select patients. After being combined with the Boari flap or psoas hitch technique, the length of intestinal segment used can also be significantly reduced. Most recent long-term results suggest that ileal ureter replacement with antireflux anastomosis seems to be remarkably free of complications, and we highly praise the distal nipple valve technique. Appendiceal interposition is available for patients with normal appendix, and usually this procedure is limited to reconstructing the right ureter. Appendiceal onlay ureteroplasty has emerged as a feasible and effective option to manage patients with complex proximal and midureteral strictures of the right side. The colon is rarely used for ureteral reconstruction because of its large caliber and mucous surface area. However, a reconfigured colon segment is a good substitute to reconstruct long-segment ureteral defects, and longterm follow up confirmed minimal complications and improved renal function. This review provides a comprehensive perspective on complex ureteral reconstruction and replacement using intestinal segments, in particular, ileal ureter replacement.

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Section: Appendiceal Interpositionmentioning

confidence: 99%

Section: Appendiceal Interpositionmentioning

confidence: 99%

Intestinal interposition for complex ureteral reconstruction: A comprehensive review

Xiong

Zhu

et al. 2020

Int J of Urology

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Stentless repair of left urethral defect with appendiceal interposition: A case report

Avci

Atıcı

Uylaş

et al. 2022

International Journal of Surgery Case Reports

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Introduction and importance Various methods have been described in the repair of ureteral defects. Here, it is aimed to present the repair performed with appendiceal interposition without any double J stent for the left ureteral defect in a patient who was operated on urgently due to obstruction with metastatic and locally advanced colon tumor. Case presentation An 82-year-old male patient was taken to an emergency operation with the diagnosis of ileus. A tumor involving the left ureter was detected in the sigmoid colon, and a 6 cm defect occurred in the left ureter after resection. This defect was repaired with appendiceal interposition without double J stent placement. Hydroureteronephrosis and stricture were not observed in the patient's 2nd and 8th-month follow-up imaging. Conclusion The appendix interposition for left ureter reconstruction is a safe and feasible option. Also, this procedure can be done without any ureteral stent.

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Appendiceal Interposition for Ureteral Stricture Disease: Technique and Surgical Outcomes

Burns

Sawyer

Selph

2020

Urology

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Left ureteral appendiceal interposition: Exercise caution and do not be mislead by postoperative radiological obstruction

Abstract: Postoperative imaging after appendiceal ureteral interposition may be difficult to interpret, misguiding the urologist towards intervention. We present a case in which radiological obstruction was not endorsed by a 99TcDTPA nephrogram, with favorable outcome after conservative treatment.

Cited by 4 publications

References 7 publications

Intestinal interposition for complex ureteral reconstruction: A comprehensive review

Intestinal interposition for complex ureteral reconstruction: A comprehensive review

Stentless repair of left urethral defect with appendiceal interposition: A case report

Appendiceal Interposition for Ureteral Stricture Disease: Technique and Surgical Outcomes

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