Reemplazo ureteral con colgajo de Boari laparoscópico: experiencia multi-institucional en 30 casos

Castillo, Octavio A.; Travassos, José; López-Fontana, Gastón

doi:10.1016/j.acuro.2012.11.017

Cited by 7 publications

(4 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Tension-free, well vascularized and water-tight anastomosis is essential to avoid ischemic complications, restriction and to provide better outcomes. 19 , 20 Improved dissection and anastomosis can be achieved in laparoscopic and robotic surgery with the clarification and enlargement of visual field with the help of bleeding-free working area obtained with the buffering effect of pneumoperitoneum. 4 , 19…”

Section: Discussionmentioning

confidence: 99%

Long Term Outcomes of Laparoscopic and Open Modified Lich-Gregoir Reimplantation in Adults: A Multicentric Comparative Study

Atar

Ekşi

Güler³

et al. 2017

Pak J Med Sci

View full text Add to dashboard Cite

Background & Objective:Obstructive ureteral pathologies in adult patients are most commonly due to ureteral strictures and secondary to surgical interventions. In this study, we aimed to compare open and laparoscopic modified Lich-Gregoir ureteral reimplantation with regards to outcomes in benign ureteral pathologies in adult patients.Methods:Between December 2008 and December 2014, 32 open cases and 29 laparoscopic cases were performed as per the data retrieved from surgical databases. All laparoscopic procedures were performed in Bakirkoy Dr. Sadi Konuk Training and Research Hospital(BEAH) and all open ureteral reimplantation procedures in Kartal Dr Lutfi Kirdar Training and Research Hospital(KEAH) and Okmeydani Training and Research Hospital(OEAH).Results:The mean operation time was significantly lower in the group of patients operated with open group (142.5 minutes versus 188.9 minutes; P< 0.0001). The mean duration of follow-up was longer in the laparoscopy group (31 versus 28 months; p< 0.0001). The mean amount of operation associated blood loss was significantly lower in patients operated laparoscopically (93.7 mL versus 214 mL; P< 0.0001). The mean VAS score obtained six hours after surgery was 6.6 ± 0.8 in open group, and 5.8 ± 0.7 in laparoscopic group (p=0.0004). The mean VAS scores measured at post-operative day 1 was 4.5 ± 0.7 in open group and 3.7 ± 0.9 in laparoscopy group. Time required to achieve the pre-operative capability of daily activities was significantly longer in open group (15 ± 1.4 days vs 11 ± 1.4 days; p< 0.0001).Conclusion:Despite open techniques provide shorter operation time and laparoscopic techniques require long learning curve, we think that laparoscopic techniques are superior to open ones since that they provide a better post-operative comfort and are better tolerated in terms of complications.

show abstract

Section: Discussionmentioning

confidence: 99%

Long Term Outcomes of Laparoscopic and Open Modified Lich-Gregoir Reimplantation in Adults: A Multicentric Comparative Study

Atar

Ekşi

Güler³

et al. 2017

Pak J Med Sci

View full text Add to dashboard Cite

show abstract

“…In 1894, Boari first described the use of a bladder flap for ureteral reconstruction in experimental animals, and in 1947 reported its use in humans with good results 3 . With the advent of minimally invasive surgery, laparoscopic ureteroplasty using a bladder flap is becoming more widely developed 4,5 . However, the above studies reported limitations with the use of bladder flaps to treat long ureteral strictures or defects because such flaps are usually used for ureteral strictures or defects ranging in length from 8 to 12 cm.…”

Section: Surgical Techniquementioning

confidence: 99%

“…Ureteroplasty using a bladder muscle flap (Boari flap) was first applied clinically in 1947 and is typically used to repair <12-cm defects of the middle and lower ureter 3,4 . We modified this technique for application to nearly full-length ureteral defects and expanded the source of the muscle flap to include the dilated renal pelvis and dilated ureter segments.…”

Section: Introductionmentioning

confidence: 99%

Treatment of Complex Ureteral Strictures or Defects with Autologous Urinary Tract Muscle Flaps

Pang

et al. 2019

Preprint

View full text Add to dashboard Cite

Background The surgical alternatives are complicated for complex ureteral strictures or long defects such as nearly full-length ureteral avulsion and recurrent ureteral strictures after pyeloplasty or ureteroplasty with severe local adhesion. This study was performed to summarize our clinical experience in the treatment of complex ureteral strictures or defects with autologous urinary tract muscle flaps. Methods We retrospectively analyzed seven patients with complex ureteral strictures or defects. The seven patients comprised three men and four women ranging in age from 37 to 61 years (average age, 46 years). The causes of ureteral lesions were nearly full-length ureteral avulsion (n = 2), postoperative ureteral stricture after sigmoid augmentation cystoplasty (n = 1), and postoperative recurrent ureteral stricture due to local inflammation and local adhesion (n = 4). The lengths of the defects in the patients with ureteral avulsion were 22 and 24 cm, and the average length of the recurrent ureteral strictures was 5.2 cm (range, 4–8 cm). The patients underwent ureteroplasty using spiral bladder muscle flaps (n = 4), muscle flaps from the dilated ureter or pelvis segment proximal to the strictures (n = 2), or a bowel segment (sigmoid) (n = 1). Six-French double-J stents were placed in the repaired ureters. Results All operations were successful, and the ureteral double-J stents were safely removed under cystoscopy 8 weeks postoperatively. All of the patients had improvement of hydronephrosis, and none had ureteral strictures on intravenous urography or contrast CT. The patient with failed pyeloplasty was found to have enlarged kidney and dilated calyx postoperatively, but the degree was less severe than preoperatively and three-dimensional CT reconstruction showed renal pelvis reduction and a patent ureter with no stenosis at the reconstruction site. Renal function was normal in all patients. Conclusions Treatment of ureteral strictures or defects with autologous urinary tract muscle flaps can be performed in some complicated cases with good results.

show abstract

“…In a large multi-institutional study, Castillo et al [18] reported the outcomes of 30 patients who were treated with a laparoscopic Boari flap. The mean length of ureteral resection was 7 cm (range, 5-20 cm), mean operative time was 161 minutes, and severe complications occurred in three patients.…”

Section: Minimally Invasive Surgical Techniquesmentioning

confidence: 99%

Laparoendoscopic Management of Midureteral Strictures

2014

View full text Add to dashboard Cite

The incidence of ureteral strictures has increased worldwide owing to the widespread use of laparoscopic and endourologic procedures. Midureteral strictures can be managed by either an endoscopic approach or surgical reconstruction, including open or minimally invasive (laparoscopic/robotic) techniques. Minimally invasive surgical ureteral reconstruction is gaining in popularity in the management of midureteral strictures. However, only a few studies have been published so far regarding the safety and efficacy of laparoscopic and robotic ureteral reconstruction procedures. Nevertheless, most of the studies have reported at least equivalent outcomes with the open approach. In general, strictures more than 2 cm, injury strictures, and strictures associated either with radiation or with reduced renal function of less than 25% may be managed more appropriately by minimally invasive surgical reconstruction, although the evidence to establish these recommendations is not yet adequate. Defects of 2 to 3 cm in length may be treated with laparoscopic or robot-assisted uretero-ureterostomy, whereas defects of 12 to 15 cm may be managed either via ureteral reimplantation with a Boari flap or via transuretero-ureterostomy in case of low bladder capacity. Cases with more extended defects can be reconstructed with the incorporation of the ileum in ureteral repair.

show abstract

Reemplazo ureteral con colgajo de Boari laparoscópico: experiencia multi-institucional en 30 casos

Cited by 7 publications

References 15 publications

Long Term Outcomes of Laparoscopic and Open Modified Lich-Gregoir Reimplantation in Adults: A Multicentric Comparative Study

Long Term Outcomes of Laparoscopic and Open Modified Lich-Gregoir Reimplantation in Adults: A Multicentric Comparative Study

Treatment of Complex Ureteral Strictures or Defects with Autologous Urinary Tract Muscle Flaps

Laparoendoscopic Management of Midureteral Strictures

Contact Info

Product

Resources

About