Replacement of the Ureter by Small Intestine: Clinical Application and Results of the Ileal Ureter in 89 Patients

Boxer, Richard J.; Fritzsche, Peggy J.; Skinner, Donald G.; Kaufman, Joseph J.; Belt, Elmer; Smith, Robert B.; Goodwin, Willard E.

doi:10.1016/s0022-5347(17)56972-4

Cited by 185 publications

(61 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Case reports to retrospective studies support its use, with overall success rates of up to 81% [44,47,59,63,88]. Bacteriuria and vesico-ileal reflux are common, but do not worsen renal function [63,88]. For extensive bilateral ureteric injuries, a segment of ileum can be tailored as a conduit for both kidneys.…”

Section: Ileal Interpositionmentioning

confidence: 99%

See 1 more Smart Citation

Diagnosis and management of ureteric injury: an evidence‐based analysis

Brandes¹,

Coburn²,

et al. 2004

View full text Add to dashboard Cite

The Consensus on Genitourinary Trauma continues this month with an evidence‐based analysis, by a team of experts under the chairmanship of Dr Jack McAninch, of current reports on the diagnosis and management of ureteric trauma. This is quite a unique document, and of interest to all urologists; not only as a consensus on how this condition should be managed, but also as a model of how to review current publications.

show abstract

Section: Ileal Interpositionmentioning

confidence: 99%

“…This can be used alone or in conjunction with a psoas hitch or anterior bladder wall flap to minimize the segment of ileum used. Reported complications of ileal interposition include obstruction, prolonged mucus formation, stones, recurrent infections and metabolic acidosis [59,63,88].…”

Section: Ileal Interpositionmentioning

confidence: 99%

Diagnosis and management of ureteric injury: an evidence‐based analysis

Brandes¹,

Coburn²,

et al. 2004

View full text Add to dashboard Cite

show abstract

“…All cases had a ureteric defect that was too long to be repaired using internal urinary tissue and so the decision of ileal ureter substitution was taken to compensate this defect. Ileal ureter replacement became now an established procedure for ureteric reconstruction especially after the urologists gained more experience in bowel surgery (12). Several studies reported encouraging results regarding surgical ou-tcome and renal function (2,10), however common drawbacks were reported mostly attributed to the absorbing and secreting criteria of the involved ileal segment such as hyperchloremic metabolic acidosis and excess mucus production and also to the wide caliber refl uxing ileal ureter with subsequent progressive dilatation, functional obstruction and recurrent UTI (10,13).…”

Section: Discussionmentioning

confidence: 99%

Application of Yang-Monti Principle in Ileal Ureter Substitution: Is It a beneficial Modification?

2012

View full text Add to dashboard Cite

Purpose: Ureteric substitution using the Yang-Monti principle was reported as a modifi cation of simple ileal ureter replacement. In this study, we evaluate its safety, surgical outcome and impact on renal function. Materials and Methods: Sixteen patients underwent ileal ureter replacement using the Yang-Monti principle to overcome long ureteric defects. Exclusion criteria included patients with elevated serum creatinine > 1.8 mg/dL, infl ammatory bowel syndrome or irradiated bowel. Antirefl ux implantation into the bladder was performed in 12 patients while 4 patients with intact healthy lower ureters underwent distal ileal-ureteral anastomosis. Follow-up protocol was carried out for up to 3 years in 9 patients. Results: No intra-operative or postoperative mortality or signifi cant complications occurred. There were minor complications in the form of urinary leakage that necessitated prolonged ureteric stenting in one patient, superfi cial wound infection in another one and 3 patients developed treatable urinary tract infection without late harmful effects. During follow up, no excess mucus production or metabolic abnormalities were encountered. All patients had preserved renal function (improved in 13 patients and stabilized in 3) without any evidence of urinary obstruction. Conclusions: The reconfi gured ileal segment for ureteric substitution is a safe technique with an excellent outcome. It uses short ileal segments for reconstruction of an ileal tube of adequate length and optimal caliber that permits easy antirefl ux implantation into the bladder so it is not associated with excess mucus production or metabolic abnormalities and offers a durable preservation of renal function without urinary obstruction.

show abstract

“…Various surgical techniques have been described for the substitution of long ureteric segments, and the most commonly performed is ileal ureteric replacement [1][2][3][4][5][6][7][8]. Although many surgeons have reported a high success rate with ureteric substitution using the ileum, others have expressed scepticism regarding the long-term efficacy and applicability of this approach [4][5][6][7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Ileal ureteric replacement with an ileo‐psoas muscle tunnel antirefluxing technique for the treatment of long segment ureteric strictures

Lin

et al. 2008

BJU International

View full text Add to dashboard Cite

OBJECTIVES To develop and report our initial experience with a novel antirefluxing technique for segmental ileal ureteric replacement for the treatment of long ureteric strictures. PATIENTS AND METHODS Between January 2000 and January 2007, 12 cases of ureteric strictures (nine bilateral and three unilateral) were treated using a novel surgical technique in which the ureter was replaced with a segment of ileum using an end‐to‐side anastomosis. An antireflux valve was constructed by fixing the distal part of upper ureter (4 cm) between the psoas muscle and ileal segment (the ileo‐psoas tunnel technique). The distal ileum was connected to the urinary bladder with an end‐to‐side anastomosis. RESULTS The 12 cases were followed‐up for a mean (range) of 39.42 (12–64) months. There were no cases of pyelonephritis or signs of renal failure after surgery. There was dramatic improvement in hydronephrosis, as assessed by intravenous urography, in the 4–9 months after surgery. Cystography showed no evidence of ileo‐ureteric reflux. Mild hyperchloraemic acidosis was detected in two patients and was successfully treated with oral alkalization. CONCLUSIONS In our initial experience, ileal ureteric replacement combined with the ileo‐psoas tunnel antirefluxing technique is a highly effective procedure for the treatment of ureteric strictures.

show abstract

Replacement of the Ureter by Small Intestine: Clinical Application and Results of the Ileal Ureter in 89 Patients

Cited by 185 publications

References 27 publications

Diagnosis and management of ureteric injury: an evidence‐based analysis

Diagnosis and management of ureteric injury: an evidence‐based analysis

Application of Yang-Monti Principle in Ileal Ureter Substitution: Is It a beneficial Modification?

Ileal ureteric replacement with an ileo‐psoas muscle tunnel antirefluxing technique for the treatment of long segment ureteric strictures

Contact Info

Product

Resources

About