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. 2019 Jan 18;19(1):9.
doi: 10.1186/s12893-019-0472-1.

Technical considerations and outcomes for ileal ureter replacement: a retrospective study in China

Wenlong Zhong  1 , Peng Hong  1 , Guangpu Ding  1 , Kunlin Yang  1 , Xuesong Li  2 , Junsheng Bao  3 , Guochang Bao  4 , Liang Cui  5 , Changping Men  6 , Zhe Li  7 , Peng Zhang  7 , Ning Chu  8 , Liqun Zhou  9
Affiliations

Technical considerations and outcomes for ileal ureter replacement: a retrospective study in China

Wenlong Zhong et al. BMC Surg. .

Abstract

Background: Ileal ureter replacement is an alternative treatment for various length ureter defects. We present our experience and outcome of ileal ureter replacement in China.

Methods: We retrospectively collected data of patients who underwent ileal ureter replacement between January 2010 and January 2015. We reviewed the medical history, indications for surgery, operative data, perioperative data, and outcomes. Besides, follow-up data included symptom, urine routine test, serum creatinine, serum electrolyte status, and radiographic test.

Results: There were 23 patients who underwent ileal ureter replacement by the same surgeon. Twenty patients were performed unilateral ileal ureter replacement, two patients underwent a combination of ileal ureter replacement and Boari flap-psoas hitch, and one received bilateral ileal ureter replacement. Among these patients, the main cause leading to surgical treatment was iatrogenic injuries (n = 15), especially urinary surgery procedure (n = 11). The median follow-up time was 45 months. There were 6 early complications and 6 late complications after operation. Only one patient suffered from small bowel-related complication and was cured by conservative treatment. Only the patient who underwent bilateral ileal ureter replacement had metabolic acidosis. And 22 patients (95.7%) had a good renal function.

Conclusions: Ileal ureter replacement is an efficacious and safe procedure for the therapy of long ureteral defects. With appropriate technical considerations, the complication rate may decrease.

Keywords: Ileum; Outcome; Reconstructive surgical procedures; Ureter replacement.

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Conflict of interest statement

The authors report no conflict of interest.

Figures

Fig. 1
Fig. 1
Our modified stapled side-to-side anastomosis. a Side-to-side anastomosis at the anti-mesenteric edge, completed using a linear stapler through the vertical incision, b. Open ends of the proximal and distal ilea, closed using another linear stapler load, c and d. The anastomotic edge was strengthened by interrupted Lembert sutures
Fig. 2
Fig. 2
The anti-reflux nipple valve for ileal ureter substitution
Fig. 3
Fig. 3
The combination of ileal ureter replacement and Boari flap-psoas hitch technique
Fig. 4
Fig. 4
Different types of ureteral replacement. a unilateral ileal ureter replacement, b. bilateral ileal ureter replacement, c. combined ileal–ureter substitution and Boari flap–psoas hitch
See this image and copyright information in PMC

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