Robotic Ureteroplasty with Buccal Mucosa Graft for the Management of Complex Ureteral Strictures

Lee, Ziho; Waldorf, Benjamin; Cho, Eric Y.; Liu, Jeffrey; Metro, Michael J.; Eun, Daniel

doi:10.1016/j.juro.2017.06.097

Cited by 55 publications

(22 citation statements)

References 24 publications

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“…Hence, only few series, mainly single case reports or small cohorts (5-19 patients) on BMG in ureteric reconstruction have been published to date (Table 4) [15][16][17][18][19][20][21].…”

Section: Discussionmentioning

confidence: 99%

“…Success rates of these studies are excellent and range between 83% and 100% and no major complications occurred [15][16][17][18][19][20][21]. Some of the recent studies have described a robotic assisted laparoscopic approach [19,21]. However, many patients who need a proximal ureteral reconstruction have had major surgery before and may not be eligible for laparoscopic surgery.…”

Section: Discussionmentioning

confidence: 99%

“…All of the published series have some limitations which are typical for rare diseases: inhomogeneity of the treated patients with different localizations (Table 4) and origins of strictures (e.g., previous radiation), various techniques of BMG graft placement (Table 4), and the lack of structured information of the postoperative renal function [15][16][17][18][19][20][21].…”

Section: Discussionmentioning

confidence: 99%

“…The most recently published series reported on a robotic assisted laparoscopic approach [19,21]. This series represents the largest number or treated patients to date (n=19 patients).…”

Section: Discussionmentioning

confidence: 99%

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Open ureteroplasty with buccal mucosa graft for long proximal strictures: A good option for a rare problem

Hefermehl

Tritschler²,

Kretschmer

et al. 2020

Investig Clin Urol

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Purpose: To report a single surgeon experience with one year follow-up after open ureteroplasty with buccal mucosa graft (OU-BMG) in the rare situation of long segment proximal ureteral strictures. Materials and Methods: Four patients with long segment proximal ureteral stricture underwent OU-BMG between February and July 2017. Functional outcome was assessed by pre-and postoperative serum creatinine, ultrasound and renal scintigraphy as well as patient reported outcomes. Results: Four patients with an average stricture length of 4 cm underwent OU-BMG between February and July 2017. No major postoperative complications occurred. Retrograde uretero-pyelography 6 weeks postoperatively revealed a watertight anastomosis followed by immediate emptying of the renal pelvis and ureter in all four patients. Ureteroscopy at this time showed a wide lumen with well-vascularized pink mucosa. After a mean follow-up time of 12.5 (12-14) months, postoperative serum creatinine was unimpaired. Renal scintigraphy revealed no signs of renal obstruction. With regard to intraoral surgery, no difficulties with mouth opening or intraoral dryness or numbness were reported. Conclusions: For patients with long segment ureteral strictures OU-BMG is a safe technique with excellent surgical and functional outcomes. Hence, the application of this technique should be encouraged and regarded as one of the standard options in case of this rare problem.

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“…Hence, only few series, mainly single case reports or small cohorts (5-19 patients) on BMG in ureteric reconstruction have been published to date (Table 4) [15][16][17][18][19][20][21].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…The most recently published series reported on a robotic assisted laparoscopic approach [19,21]. This series represents the largest number or treated patients to date (n=19 patients).…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Open ureteroplasty with buccal mucosa graft for long proximal strictures: A good option for a rare problem

Hefermehl

Tritschler²,

Kretschmer

et al. 2020

Investig Clin Urol

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“…Sindsdien zijn enkele caseseries beschreven waarin de BMG is toegepast bij lange proximale ureterstricturen. De laatste publicaties beschrijven het gebruik van de robotgeassisteerde techniek [10,11]. Wij hebben in onze casus bewust voor de open benadering gekozen, vanwege de complexiteit van de eerdere robotgeassisteerde procedure en de complicaties die daarna optraden (urinoom met abcedering, behandeld met percutane drainage).…”

Section: Discussieunclassified

Case report. Buccal mucosa graft voor UPJ-reconstructie na een niet-geslaagde robotgeassisteerde pyelumplastiek

et al. 2019

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Samenvatting Proximale ureterstricturen zijn een uitdaging voor de reconstructieve chirurgie. Transuretero-ureterostomie, ileuminterpositie en autotransplantatie zijn vaak genoemde mogelijkheden. Een wat minder bekend type reconstructie, de doorgaans succesvolle buccal mucosa graft (BMG) ureteroplastiek, is in kleine series in de literatuur beschreven. Wij beschrijven een casus waarin een BMG werd gebruikt voor herstel van een strictuur ter plaatse van de proximale ureter/uretero-pelviene junctie (UPJ) na iatrogeen ureterletsel en een niet-geslaagde robotgeassisteerde pyelumplastiek. Aan de hand van deze casus willen wij deze weinig bekende reconstructieve optie bij urologen onder de aandacht brengen. Trefwoorden graft van wangslijmvlies • reconstructieve urologie • ureterstricturen • UPJ Case report. Use of buccal mucosa for UPJ reconstruction after failed robot-assisted pyeloplasty Abstract Reconstructive surgery for proximal ureteral strictures is challenging. Transureteroureterostomy, ureteroileal interposition and autotransplantation are the methods most described. In literature, a somewhat less known type of reconstruction, the usually successful buccal mucosa graft (BMG) ureteroplasty is described in small case-series. We describe a case in which a BMG was used for the repair of a proximal ureteral/uteropelvine junction (UPJ) stricture following iatrogenic ureteral laceration and failed robot-assisted pyeloplasty. With this case-report we want to bring this less well known option of reconstruction to the attention of all urologists.

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Robotic‐assisted appendiceal onlay flap ureteroplasty combined with ureteral reimplantation for multifocal ureteral strictures: Case report and technical description

Xiao,

Zhou,

Chai

et al. 2023

Robotics Computer Surgery

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BackgroundTo describe the surgical technique of robotic‐assisted appendiceal onlay flap ureteroplasty combined with ureteral reimplantation to repair unilateral multifocal ureteral strictures in one stage and report 9‐month follow‐up outcomes.MethodA longitudinal ventral incision of proximal ureter strictures No. 1 and 2 was performed, and the appendix was detubularised along its antimesenteric border. Then, the appendiceal onlay flap was anastomosed with the spatulated ureter in an onlay fashion. To manage the distal ureteral stricture No. 3, ureteral reimplantation was performed in a tension‐free manner.ResultsVoiding cystourethrography and antegrade urography showed urine regurgitation into the ureter without dilation and no obstruction of the reconstructed ureteral segment 7 weeks after surgery. No postoperative complications occurred during the 9‐month follow‐up.ConclusionsRobotic‐assisted appendiceal onlay flap ureteroplasty combined with ureteral reimplantation appears to be a safe and effective surgical method for repairing the unilateral multifocal ureteral strictures.

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Robotic Ureteroplasty with Buccal Mucosa Graft for the Management of Complex Ureteral Strictures

Abstract: Robotic ureteroplasty with a buccal mucosa graft is associated with low inherent morbidity. It is an effective way to manage complex proximal and mid ureteral strictures.

Cited by 55 publications

References 24 publications

Open ureteroplasty with buccal mucosa graft for long proximal strictures: A good option for a rare problem

Open ureteroplasty with buccal mucosa graft for long proximal strictures: A good option for a rare problem

Case report. Buccal mucosa graft voor UPJ-reconstructie na een niet-geslaagde robotgeassisteerde pyelumplastiek

Robotic‐assisted appendiceal onlay flap ureteroplasty combined with ureteral reimplantation for multifocal ureteral strictures: Case report and technical description

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