Appendiceal Interposition for Ureteral Stricture Disease: Technique and Surgical Outcomes

Burns, Zachary R.; Sawyer, K.; Selph, J. Patrick

doi:10.1016/j.urology.2020.07.078

Cited by 14 publications

(23 citation statements)

References 15 publications

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“…From this perspective, end-to-end anastomosis with a section of appendix can repair longer ureteral defects in contrast with the appendiceal onlay technique. In addition, Burns et al reported eleven adult patients who underwent ureteral appendiceal interposition for right or left ureteral strictures and achieved an 83.3% success rate (25). Objectively speaking, we only perform appendiceal onlay flap ureteroplasty at present but do not deny the feasibility of appendiceal interposition.…”

Section: Discussionmentioning

confidence: 93%

Robotic ureteroplasty with appendiceal onlay flap: an update on the outcomes of 18-month follow-up

Wang¹,

Li²,

Fan³

et al. 2022

Transl Androl Urol

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Background: To describe our technical experience of robotic appendiceal onlay flap ureteroplasty (RAUP) for complex ureteral stricture disease and report the updated analysis of 18-month follow-up outcomes.Methods: Since May 2019, nine patients with right ureteral strictures have undergone RAUP in our medical centre. Patients' perioperative data and follow-up information were collected prospectively. Patients were excluded in present study if the postoperative follow-up time was less than 6 months.Results: Eight patients were recruited. Proximal ureteric strictures were present in 5 patients, and 3 patients had middle ureteric strictures. The mean stricture length was 4.3 cm (range, 3.0-6.0 cm). Nephrostomy was performed in 4 patients, and 4 patients had indwelling double-J ureteral stents before they were admitted to our hospital. All operations were implemented successfully without intraoperative complications. The mean operation time was 162 minutes (range, 135-211 minutes), and the mean estimated blood loss was 78 mL (range, 30-200 mL). The mean postoperative hospital stay was 8 days (range, 4-12 days).No patients had high-grade postoperative complications (Clavien-Dindo III and IV) 30 days after surgery.At a mean follow-up of 18 months (range, 6-28 months), all patients were not needed further surgical intervention and could be considered successful. But 2 cases still have stable mild hydronephrosis without symptoms such as flank pain or fever.Conclusions: RAUP is a workable option for managing long-segment (3-6 cm) proximal and middle ureteral strictures of the right side. The outcomes of 18-month follow-up are satisfactory.

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Section: Discussionmentioning

confidence: 93%

Robotic ureteroplasty with appendiceal onlay flap: an update on the outcomes of 18-month follow-up

Wang¹,

Li²,

Fan³

et al. 2022

Transl Androl Urol

View full text Add to dashboard Cite

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“…Generally, appendiceal interpositions are performed on the right-side [4] , [5] , [6] , [7] , [8] , [9] . Applications performed on the left side are technically difficult and have a higher probability of complications.…”

Section: Discussionmentioning

confidence: 99%

“…Applications performed on the left side are technically difficult and have a higher probability of complications. There are a limited number of studies in the literature that performed appendiceal interposition to left ureteral defects [5] , [6] , [9] , [10] , [11] . In the literature review, it was observed that appendix interposition was applied to the left ureter in 15 of 64 patients [5] , [6] , [7] , [8] , [9] , [10] , [11] , [12] .…”

Section: Discussionmentioning

confidence: 99%

“…There are a limited number of studies in the literature that performed appendiceal interposition to left ureteral defects [5] , [6] , [9] , [10] , [11] . In the literature review, it was observed that appendix interposition was applied to the left ureter in 15 of 64 patients [5] , [6] , [7] , [8] , [9] , [10] , [11] , [12] . Complications have been reported to be higher in appendiceal interposition surgeries using isoperistaltic [13] .…”

Section: Discussionmentioning

confidence: 99%

“…Double J catheters are used in the treatment of conditions such as ureteral reconstructive surgery, obstructive uropathy, extracorporeal real shock wave lithotripsy, and obstructive anuria [14] . Ureteral stents are also used during intestinal interpositions applied to ureteral defects [5] , [6] , [7] , [8] , [11] , [12] . Forgetting and not removing these catheters cause high complications [14] .…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Stentless repair of left urethral defect with appendiceal interposition: A case report

Avci

Atıcı

Uylaş

et al. 2022

International Journal of Surgery Case Reports

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Introduction and importance Various methods have been described in the repair of ureteral defects. Here, it is aimed to present the repair performed with appendiceal interposition without any double J stent for the left ureteral defect in a patient who was operated on urgently due to obstruction with metastatic and locally advanced colon tumor. Case presentation An 82-year-old male patient was taken to an emergency operation with the diagnosis of ileus. A tumor involving the left ureter was detected in the sigmoid colon, and a 6 cm defect occurred in the left ureter after resection. This defect was repaired with appendiceal interposition without double J stent placement. Hydroureteronephrosis and stricture were not observed in the patient's 2nd and 8th-month follow-up imaging. Conclusion The appendix interposition for left ureter reconstruction is a safe and feasible option. Also, this procedure can be done without any ureteral stent.

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Robotic‐assisted appendiceal onlay flap ureteroplasty combined with ureteral reimplantation for multifocal ureteral strictures: Case report and technical description

Xiao,

Zhou,

Chai

et al. 2023

Robotics Computer Surgery

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BackgroundTo describe the surgical technique of robotic‐assisted appendiceal onlay flap ureteroplasty combined with ureteral reimplantation to repair unilateral multifocal ureteral strictures in one stage and report 9‐month follow‐up outcomes.MethodA longitudinal ventral incision of proximal ureter strictures No. 1 and 2 was performed, and the appendix was detubularised along its antimesenteric border. Then, the appendiceal onlay flap was anastomosed with the spatulated ureter in an onlay fashion. To manage the distal ureteral stricture No. 3, ureteral reimplantation was performed in a tension‐free manner.ResultsVoiding cystourethrography and antegrade urography showed urine regurgitation into the ureter without dilation and no obstruction of the reconstructed ureteral segment 7 weeks after surgery. No postoperative complications occurred during the 9‐month follow‐up.ConclusionsRobotic‐assisted appendiceal onlay flap ureteroplasty combined with ureteral reimplantation appears to be a safe and effective surgical method for repairing the unilateral multifocal ureteral strictures.

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Appendiceal Interposition for Ureteral Stricture Disease: Technique and Surgical Outcomes

Cited by 14 publications

References 15 publications

Robotic ureteroplasty with appendiceal onlay flap: an update on the outcomes of 18-month follow-up

Robotic ureteroplasty with appendiceal onlay flap: an update on the outcomes of 18-month follow-up

Stentless repair of left urethral defect with appendiceal interposition: A case report

Robotic‐assisted appendiceal onlay flap ureteroplasty combined with ureteral reimplantation for multifocal ureteral strictures: Case report and technical description

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