Management of long ureteral stenosis: Alternatives to indwelling ureteral stents

Roux, Sabine Le; Pettenati, C.; Dariane, C.; Sbizzera, M.; Dominique, I.; Matillon, X.; Toinet, T.; Bessède, Thomas; Drouin, S.; Nouaille, A.; Champy, C.; Timsit, Marc Olivier; Méjean, Arnaud

doi:10.1016/s1569-9056(19)31063-2

Cited by 1 publication

(3 citation statements)

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“…Although not statistically significant, the findings suggest fewer long-term complications due to urinary tract preservation [71]. Roux et al [65] found shorter hospital length of stay among patients undergoing RA ( n = 8) compared to ileal substitution ( n = 14) (8.4 vs. 15.0 days, P = 0.001); however, 3 (37.5%) RA cases required surgical revision compared to none in the ileal substitution group – and one (12.5%) RA patient underwent nephrectomy for renal vein thrombosis. Otherwise, there was no difference in operating time, blood loss, complications, or postoperative changes in renal function between cohorts ( P > 0.05) [65].…”

Section: Ureteral Trauma and Stricturesmentioning

confidence: 81%

“…Roux et al [65] found shorter hospital length of stay among patients undergoing RA (n ¼ 8) compared to ileal substitution (n ¼ 14) (8.4 vs. 15.0 days, P ¼ 0.001); however, 3 (37.5%) RA cases required surgical revision compared to none in the ileal substitution group -and one (12.5%) RA patient underwent nephrectomy for renal vein thrombosis. Otherwise, there was no difference in operating time, blood loss, complications, or postoperative changes in renal function between cohorts (P > 0.05) [65]. Overall, with 17% of cases performed for ureteral stricture or fistula [4], RA for ureteric replacement demonstrates approximately 90% graft success rate in larger series without deleterious effects on renal function [15,64,[72][73][74].…”

Section: Ureteral Trauma and Stricturesmentioning

confidence: 99%

“…The decision lies between harvesting bowel and introducing it into the urinary tract, or complex vascular reconstruction – and should be based on operative team experience. Robotic ureteroplasty with buccal mucosal grafts have 87% treatment success with low major postoperative complications (5.6%) over median 27.5 months in high-volume centers; reconstructed stricture lengths, however, are slightly shorter (median of 3.0 cm) compared to strictures managed with RA (median 4 to mean 9.2) or ileal interposition (mean 5.9–9.1 cm) [28 ▪▪ ,63–66].…”

Section: Ureteral Trauma and Stricturesmentioning

confidence: 99%

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Indications for and results of renal autotransplantation

Han

Johnson

Schulster

et al. 2022

Current Opinion in Nephrology &Amp; Hypertension

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Purpose of reviewTo understand the indications and outcomes of renal autotransplantation, and when to consider this unique procedure for patients. Recent findingsRenal autotransplantation confers acceptably low rates of graft failure and prevents need for long-term dialysis. Renal autotransplantation remains an important management strategy in very select patients for complex renovascular disease, ureteral stricture disease, ureteral trauma, upper urinary tract urothelial carcinoma, renal cell carcinoma, and Loin-Pain Hematuria Syndrome. With advancements in minimally invasive procedures, the application of renal autotransplantation for refractory stone disease is rare but exists. Robot-assisted laparoscopic renal autotransplantation demonstrates reproducible graft success and complication rates with improved perioperative outcomes (ex. hospital length of stay) --though comparative studies are lacking. Patients would benefit from a multidisciplinary approach from renal transplant surgeons, vascular surgeons, urologists, nephrologists, dieticians, pain management providers, social workers, and psychiatrists.

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Section: Ureteral Trauma and Stricturesmentioning

confidence: 81%