An experimental study of tubularized peritoneal free grafts as ureteral mucosa substitutes / 中华泌尿外科杂志

ABSTRACT

Objective To investigate the feasibility of reconstruction of ureter with tubularized peritoneal free grafts for the treatment of avulsion of ureteral mucosa using animal models.Methods Twelve adult dogs were randomly divided into the reconstruction group(n=6) and the control group(n=6).Firstly,the model of avulsion of ureteral mucosa about 3-5 cm long was made.In reconstruction group,tubularized peritoneal free grafts and ureteral stents were placed in the injured ureters;and in control group,no operation was performed but to place the stents into the ureter.The curative effect was observed by IVU and histological examination 10 weeks after operation.Results In reconstruction group,IVU showed normal size and morphology of the kidneys.There was no hydronephrosis,and no obvious stricture of the part of ureter in which peritoneal free grafts were used as mucosa substitutes.In control group,IVU showed no image or only obscure enlarged outlines of the kidneys,and no image of the ureters.Atresia or severe stricture of the ureters was observed in all dogs in control group;while in reconstruction group,the peritoneal membrane was replaced by integrate transitional epithelium,and no obvious stricture was observed.Subepithelial abundant neovascularization was also seen.Conclusions For avulsion of ureteral mucosa exceeding 3 cm,placing stents only will lead to ureteral stricture or atresia,reconstruction using tubularized peritoneal free grafts as mucosa substitutes is an effective method.