urovestВестник урологииUrology Herald2308-6424Rostov State Medical University10.21886/2308-6424-2024-12-4-102-113urovest-908Research ArticleОБЗОРЫ ЛИТЕРАТУРЫREVIEWS ARTICLEРеконструкция протяжённых дефектов мочеточников с использованием участков тонкой и толстой кишкиReconstruction of extended ureteral defects using sections of the ileum and colonhttps://orcid.org/0000-0003-3764-6131КотовС. В.KotovS. V.

Котов Сергей Владиславович — д-р мед. наук, профессор.

Москва

Sergey V. Kotov — Dr.Sc.(Med), Full Prof.

Moscow

urokotov@mail.ruhttps://orcid.org/0009-0005-5959-790XГаинаО. В.GainaO. V.

Гаина Оксана Владимировна.

Москва

Oksana V. Gaina.

Moscow

oksana.urologia@mail.ruРоссийский национальный исследовательский медицинский университет им. Н.И. Пирогова; Городская клиническая больница No 1 им. Н.И. Пирогова; Московский многопрофильный клинический центр «Коммунарка»РоссияPirogov Russian National Research Medical University; Pirogov City Clinical Hospital No. 1; Moscow Multidisciplinary Clinical Centre "Kommunarka"Russian FederationРоссийский национальный исследовательский медицинский университет им. Н.И. ПироговаРоссияPirogov Russian National Research Medical UniversityRussian Federation202404092024124102113Copyright © Котов С.В., Гаина О.В., 20242024Котов С.В., Гаина О.В.Kotov S.V., Gaina O.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.urovest.ru/jour/article/view/908

Распространённость протяжённых стриктур мочеточника за последние 10 лет прогрессивно увеличивается, что связано с ростом количества эндоскопических операций, расширением показаний к хирургическому лечению онкологических больных и осложнениями, вызванными лучевой терапией, или после лучевой терапии. Коррекция протяжённой стриктуры мочеточника при недостатке тканей мочевыделительной системы для замещения дефекта или вовлеченности их в патологический процесс требует заместительной реконструкции сегментом тонкой или толстой кишки. В данной обзорной статье освещены варианты реконструкций мочеточников с использованием участков подвздошной и толстой кишок, а также использование в качестве трансплантата аппендикса. В результате были проанализированы данные об эффективности, частоте послеоперационных осложнений, проведена оценка преимуществ и недостатков различных хирургических методик уретеропластики. Сделан вывод о необходимости проведения дальнейших научно-практических исследований и оценке отдалённых результатов для решения остающихся нерешённых проблем.

The incidence of extended ureteral strictures has been on the rise in the past decade. This increase is attributed to the growing number of endoscopic surgeries, expanded criteria for surgical treatment of cancer patients, and complications from radiation therapy. When correcting an extended ureteral stricture, if there is a lack of urinary system tissues to replace the defect or if they are involved in the pathological process, replacement reconstruction using a segment of small or large intestine becomes necessary. Options for ureteral reconstructions using ileum and colon sections were discussed, as well as the use of the appendix as a graft. Data on the effectiveness and frequency of postoperative complications were analysed, and the pros and cons of different surgical techniques for ureteroplasty were evaluated. It is necessary to conduct further scientific and practical research and evaluation of long-term results to solve the remaining unclear problems and to inform the doctors of our country about the existence of this pathology.

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The authors declare that there are no conflicts of interest present.