Laparoscopic totally intracorporeal ileal ureter replacement: a multi-institutional study

Abstract

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.

Keywords:

• Laparoscopy
• ureter reimplantation
• ileal ureter
• ureteral strictures

Declaration of interest

Drs Alexey Kochkin, Theodoros Tokas, Eduard Gallyamov, Rafael Biktimirov, Andrey Sanzharov, Vladimir Sergeev, Sergey Popov, and Ali Serdar Gözen have no conflicts of interest or financial ties to disclose.