THE RESULTS OF LAPAROSCOPIC ILEAL URETERAL REPLACEMENT
https://doi.org/10.21886/2308-6424-2015-0-4-16-28
Abstract
Purpose. To evaluate the long-term results and effectiveness of laparoscopic ileal ureteral replacement. Material and Methods. To this study included the results of ileal ureteral substitution in 17 patients. In 10 patients we used open, in 7 patients used laparoscopic approach. Technique of operation (mobilization of ureter, ileal resection, creation of ureteroileal and ileobladder anastomoses) was similar in the both groups. We performed comparative analysis parameters, such as operative time, blood loss, narcotic analgesic, hospital stay and time to convalescence. Results. No conversion in patients who were underwent laparoscopic ileal replacement of ueter. Operative time was longer for 70 min in laparoscopic group, but this difference wasn’t significantly (p < 0,05). Narcotic analgesic use was dramatically less for the laparoscopic group than for the open group (40 mg versus 240 mg, p < 0,05). Hospital stay was significantly less in laparoscopic group (6 d versus 9 d, p < 0,05). Preoperative and postoperative serum creatinine, bicarbonate and chloride levels were unchanged for the laparoscopic and open groups. Moderate metabolic acidosis developed in 1 patient in open group. Time to convalescence was significantly less for the laparoscopic group (4 weeks versus 5,5 weeks, p < 0,05). Conclusion. Ileal ureteral substitution using laparoscopic approach is an effective and minimally invasive procedure. Compared with open procedures this technique allows to decrease trauma of surgery, hospital stay and time convalescence.
About the Authors
B. K. Komyakov
North-Western State Medical University named by I.I.Mechnikov
Russian Federation
Russian Federation
B. G. Guliev
North-Western State Medical University named by I.I.Mechnikov
Russian Federation
Russian Federation
References
1. Комяков, Б.К., Гулиев Б.Г. Хирургия протяженных сужений мочеточников. // Б.К. Комяков, Б.Г. Гулиев. – СПб., Диалект, 2005. – 256 с.
2. Chung, B.I. The use of bowel for ureteral replacement for complex ureteral reconstruction: long-term results. / Chung B.I., Hamawy K.J., Zinman L.N. et al. // J. Urol. – 2006. – Vol. 175. – P. 179 – 183.
3. Armatys, S.A. Use of ileum as ureteral replacement in urological reconstruction. / Armatys S.A., Mellon M.J., Beck S.D., et al. // J. Urol. – 2009. – Vol. 181. – P. 177 – 181.
4. Wolff, B. Long-term functional outcomes after ileal ureter substitution: a single-center experience. / Wolff B., Chartier-KAstler E., Mozer P., et al. // Urology. – 2011. – Vol. 78. – P. 692 – 695.
5. Лоран, О.Б. Использование изолированных сегментов кишечника в оперативном лечении лучевых повреждений мочевыводящих путей. / Лоран О.Б., Синякова Л.А., Серегин А.В. и др. // Урология. – 2012. – № 2. – С. 20 – 24.
6. Зубань, О.Н. Энтеропластика протяженных стриктур мочеточника туберкулезного и другого генеза. / Зубань О.Н., Скорняков С.Н., Арканов Л.В. и др. // Урология. – 2014. –№ 4. – С.10 – 15.
7. Gill, I.S. Laparoscopic ileal ureter. / Gill I.S., Savage S.J., Senagore A.J., Sung G.T. // J. Urol. – 2000. – Vol.163. – P.1199 – 1202.
8. Stein, R.J. Laparoscopic assisted ileal ureter: technigue, outcome and comparison to open procedure. / Stein R.J., Turna B., Patel N.S., et al. // J. Urol. – 2009. – Vol. 182. – P. 1032 – 1039.
9. Sim, A. Intracorporeal ileal replacement using laparoscopy and robotics. / Sim A., Todenhofer T., Mischinger J., et al. // Cent. European J. Urol. – 2014. – Vol. 67 (4). – P. 420 – 423.
10. Sim, A. Totally intracorporeal replacement of the ureter using whole-mount ileum. / Sim A., Todenhofer T., Mischinger J., et al. // J. Endourol. – 2014. – Vol.28(10). – P.1165 – 1167.
11. Хатьков, И.Е. Полностью лапароскопическая заместительная пластика праого мочточника участком подвздошной кишки. / Хатьков И.Е., Касаикин А.В., Родин Д.Б., и др. // Эндоскопичекая хирургия. – 2011. – № 1. – С. 41 – 43.
12. Комяков, Б.К. Лапароскопическая кишечная пластика мочеточника. / Комяков Б.К., Гулиев Б.Г. // Эндоскопическая хирургия. – 2015. – № 3. – С. 8 – 12.
13. Brandao, L.F. Robotic ileal ureter: a completely intracorporeal technigue. / Brandao L.F., Autorino R., Zargar H., et al. // Urology. – 2014. – Vol. 83. – P. 951 – 954.
14. Wagber, J.R. Robot-assisted ileal ureter. / Wagber J.R., Schimpf M.O., Cohen J.L. // JSLS. –2008. – Vol. 12(3). – P. 306 – 309.
15. Комяков, Б.К. Кишечная и аппендикулярная пластика мочеточников. / Б.К. Комяков. – М. ГОЭТАР-Медиа, 2015. – 415 с.
16. Kamat, N. Laparoscopy-assisted ileal ureter creation for multiple tuberculous strictures: report of two cases. / Kamat N., Khandelwal P. // J Endourol. – 2006. – Vol. 20 (6). – P. 388–393.
17. Castillo, O. Laparoscsopy-assisted ureter interposition by ileum. / Castillo O., Sunchez-Salas R., Vitagliano G. et al. // J.Endourol. – 2008. – Vol. 22. – P. 687 – 690.
18. Baneri, J.S. Total uteterectomy and ileal ureteric replacement for TCC ureter in a solitary kidney. / Baneri J.S., George A.J. // Can. Urol. Assoc. J. – 2014. – Vol. 8 (11 – 12). – P. 938 – 940.
Review
For citations:
Komyakov B.K., Guliev B.G. THE RESULTS OF LAPAROSCOPIC ILEAL URETERAL REPLACEMENT. Urology Herald. 2015;(4):16-28. (In Russ.) https://doi.org/10.21886/2308-6424-2015-0-4-16-28
Views:
1567
Email this article 
