Evolution and progress of replacement therapy, materials and reconstruction of long ureteral injuries / 中国组织工程研究

ABSTRACT

BACKGROUND: It is very difficult for urologists to choose what kind of substitute and how to reconstruct the long ureteral injuries to restore the integrity and function of the ureter. OBJECTIVE: To review recent progress and the evolution trends in the reconstruction methods of long ureteral injuries. METHODS: Relevant articles published from 1950 to 2019 were searched in PubMed, Web of Science, MEDLINE, and WanFang databases. The keywords were “ureteral injuries, ureteral replacement, biomaterial, tissue engineering, 3D bioprinting” in English and Chinese, respectively. The articles addressing ureteral replacement materials and reconstruction of ureteral injuries were selected. RESULTS AND CONCLUSION: In the reconstruction of long ureteral injury, the earliest repair method is to use autologous tissues, such as ileal, bladder muscle flap (Boari flap), and buccal mucosa graft. But such operations are difficult to avoid the damage to the surrounding tissues and organs. After that, various non-biomaterials were produced for ureteral replacement, but failed due to immune rejection and lack of peristalsis. With the development of cytology, biology and materials, the damaged tissues and organs have been regenerated by using autologous cells. Due to the development of regenerative medicine and three-dimensional printing technology, complex multi-component and multi-layered hollow tube structures that similar to their internal counterparts can be generated with three-dimensional bioprinting. But three-dimensional bioprinting cannot reconstruct the ureter and bladder with normal peristalsis and contraction function.