Management for Ureteral Stenosis: A Comparison of Robot-Assisted Laparoscopic Ureteroureterostomy and Conventional Laparoscopic Ureteroureterostomy
Journal of Laparoendoscopic&Advanced Surgical Techniques, Ahead of Print.
AbstractPurposeTo present our experience of laparoscopic and robotic ureteroplasty using onlay flap or graft for the management of long proximal or middle ureteral strictures and summarize our treatment strategies for these challenging scenarios.MethodsFrom March 2018 to January 2020, 53 patients with long proximal/middle ureteral strictures (2 –6 cm) who underwent laparoscopic or robotic onlay flap/graft ureteroplasty were retrospectively enrolled. Different reconstruction techniques were chosen based on our management strategy: pelvic flap (PF) was the first choice for proximal stricture if pelvic tissue was s...
We present a 64-year-old male with lower urinary tract symptoms, who, on evaluation had a right renal pelvic tumor on imaging and ureteroscopy. The patient underwent laparoscopic radical nephroureterectomy on clinical suspicion of upper tract urothelial carcinoma. The final histopathology revealed IgG4-related disease.
Strictures of the ureter may occur from iatrogenic injury or impacted kidney stones. Complications from ureteroscopy may result in ureteral stricture in 0,5 – 2% of patients (1). Many methods of surgical correction have been described. Long proximal ureteral strictures are generally treated by replacement of the ureter with a segment of ileum, which is associated with significant morbidity. New techniques are being described in order to minimize the m orbidity associated with classic approaches, such as ureteroplasty with buccal mucosa graft, but there are no published articles of ureteroplasty using a gonadal vein as a graft.
Conclusion: The laparoscopic, transvesical diverticulectomy is a feasible and valuable procedure with good outcomes. To avoid complications, the ureter needs to be spared meticulously.Urol Int
Publication date: Available online 12 September 2020Source: International Journal of Surgery Case ReportsAuthor(s): Giuseppe Di Buono, Giulia Bonventre, Salvatore Buscemi, Elisa Maienza, Giorgio Romano, Antonino Agrusa
CONCLUSION: Laparoscopic LEER for a laterally recurrent previously irradiated cervical cancer with concomitant sciatica was technically feasible, however, further study involving a greater number of patients and longer follow-up period is warranted to determine the stringent indications. PMID: 32808494 [PubMed - in process]
Conclusion: Spiral bladder muscle flap with vascular pedicles may be used to repair extensive ureteric injury.
Six years after living donor nephrectomy to his daughter, the 78-year-old donor presented to the emergency room with anuria for approximately 12 h. Only arterial hypertension, mildly reduced kidney function (eGFR 54 mL/min), and benign prostatic hyperplasia were known as preexisting medical conditions. In sonography, hydronephrosis III ° was visible in the right single kidney. Ureterorenoscopy revealed an occlusive tumor in the right proximal ureter, which was treated via double J stent. Biopsy showed focal invasive papillary urothelial carcinoma of G2 high grade. Preoperative staging did not show any signs of lymph no...
CONCLUSION: In the treatment of large and proximal ureteral calculi, LTU has a significantly higher single-procedure success rate and a higher rate of postoperative paralytic ileus than LRU. However, the complication was well-tolerated. The small sample size and limited, including studies, were the main limitations. PMID: 32748392 [PubMed - as supplied by publisher]