ABSTRACT
OBJECTIVE: To present long-term results of our laparoscopic intracorporeal ileal ureter replacement (LIUR) cohort, including more complex cases of laparoscopic ileocalycostomy. MATERIAL AND METHODS: We collected records of patients undergoing LIUR. Follow-up included a chemical profile and urine cultures. Imaging consisted of renal ultrasonography, excretory urography, cystography, and computer tomographic or magnetic resonance urography. RESULTS: One hundred and two patients were included. Stricture location was left (46.1%), right (39.2%), or bilateral (14.7%). No open conversion was performed. Seventy-four patients (72.5%) underwent a total ureteral unit removal. The mean operative time was 289.4 (120 - 680) minutes. The estimated blood loss was 185.2 (10-400) mL. Three patients had intraoperative complications, and fifteen had early postoperative complications. The mean postoperative hospital stay was 12.2 (7-35) days. The mean follow-up duration period was 37.7 (12-162) months. Most patients' follow-up was uneventful (88%), and seven patients presented with Grade 2 late complications. CONCLUSIONS: Intracorporeal laparoscopic ileal ureteral replacement in cases of extensive ureteral lesions offers optimal long-term outcomes and a low complication rate. Ileocalycostomy constitutes a viable option in the small group of patients with long proximal ureteral strictures and intrarenal pelvis.
Subject(s)
Ileum , Laparoscopy , Length of Stay , Operative Time , Postoperative Complications , Ureter , Humans , Laparoscopy/methods , Male , Female , Middle Aged , Adult , Ureter/surgery , Postoperative Complications/epidemiology , Postoperative Complications/etiology , Aged , Ileum/surgery , Follow-Up Studies , Retrospective Studies , Blood Loss, Surgical/statistics & numerical data , Young Adult , Intraoperative Complications/epidemiology , Ureteral Obstruction/surgery , Treatment Outcome , AdolescentABSTRACT
OBJECTIVE: To prove the feasibility, as well as the reproducibility of laparoscopic totally intracorporeal ileal ureter replacement (LIUR), by presenting a multicenter patient cohort with a long follow-up. MATERIAL AND METHODS: Records of patients undergoing different types of ureteral replacements have been collected. Follow-up included a chemical profile and urine cultures. Imaging consisted of renal ultrasonography and excretory urography, as well as a cystography or an isotopic renography when indicated. RESULTS: Forty patients were included in the study. Twelve underwent a right, 20 a left, and eight a bilateral laparoscopic ureteral replacement. The mean procedure time was 335 (150-680) minutes and the mean estimated blood loss was 221 (50-400) mL. Only three patients presented intraoperative complications, which were managed immediately, and three patients presented a Clavien III postoperative complication. Abdominal drains and nephrostomy tubes were removed after 24-36 h and 7-10 days, respectively. The mean hospital stay was 13.5 (10-35) days. Follow-up was at least six months. CONCLUSIONS: LIUR constitutes a feasible and reproducible method for the restoration of long ureteral defects.
