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• W2131665771 abstract "No AccessJournal of UrologyAdult Urology1 Feb 2012Ureteral Substitution With Reconfigured Colon: Long-Term Followup D.A. Lazica, B. Ubrig, A.S. Brandt, F.C. von Rundstedt, and S. Roth D.A. LazicaD.A. Lazica More articles by this author , B. UbrigB. Ubrig More articles by this author , A.S. BrandtA.S. Brandt More articles by this author , F.C. von RundstedtF.C. von Rundstedt More articles by this author , and S. RothS. Roth More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.09.156AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Long defects in the mid and upper ureter are not amenable to end-to-end reconstruction. Therefore, we present the long-term results of our technique with reconfigured colon segments. Materials and Methods: Between June 1998 and July 2008, 14 patients underwent ureteral replacement at our institution with reconfigured colon. In 4 patients the substitute was anastomosed to the skin as a modified colon conduit. In 10 patients it was interposed with anastomosis to the ureter in 4, to the bladder in 5 and to the afferent loop of an ileal bladder substitute in 1. Results: At a median followup of 52.4 months (range 7 to 136) excellent renal function was confirmed in 10 of 14 patients. Now at a median followup of 95.8 months (range 38 to 136) 6 patients are alive, all without an indwelling stent and with no sign of obstruction of the ureteral replacement. Metabolic disorders, mucus obstruction and stricture or adhesive ileus were absent during followup. In this series death was unrelated to the procedure. In 7 patients 11 specific reinterventions were necessary including 4 cases of prolonged stenting after surgery, 3 which required secondary drainage, 3 cases of urinary tract infection at 4 weeks and 3 and 112 months, and 1 acute bowel obstruction due to peritoneal carcinosis. Conclusions: Reconfigured colon segments can be used successfully to replace long ureteral defects. The advantages are use in patients with impaired renal function and lack of small intestine, proximity of the colon to the ureter, optimal cross-sectional diameter of the graft and less intraperitoneal surgical trauma than with ileal substitutes. References 1 : Ureteral replacement. In: The Ureter. Edited by . New York: Harper & Row1967: 579. Google Scholar 2 : Reconstruction of ureter with transverse retubularized colon segments. J Urol2001; 166: 973. Link, Google Scholar 3 : Experience in 100 patients with an ileal low pressure bladder substitute combined with an afferent tubular isoperistaltic segment. 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Link, Google Scholar 11 : The use of bowel for ureteral replacement for complex ureteral reconstruction: long-term results. J Urol2006; 175: 179. Link, Google Scholar 12 : Ureteral replacement with reconfigured colon substitute. J Urol1996; 155: 1693. Link, Google Scholar 13 : Ureteral replacement using the Yang-Monti principle: long-term follow-up. Urology2006; 67: 476. Google Scholar 14 : Risk of bowel dysfunction with diarrhea after continent urinary diversion with ileal and ileocecal segments. J Urol1995; 154: 1696. Link, Google Scholar 15 : The use of bowel in urology: Metabolic and nutritional complications. Urol Clin North Am1997; 24: 715. Google Scholar 16 : Optimization of replacement of the ureter by ileum. J Urol1991; 146: 306. Link, Google Scholar 17 : Bridging long ureteral defects using the Yang-Monti principle. J Urol2003; 169: 1074. Link, Google Scholar 18 : Ureteric reconstruction with reconfigured ileal segments according to Yang-Monti: A 4-year prospective report. Urologe A2010; 49: 262. Google Scholar Department of Adult and Pediatric Urology, University of Witten/Herdecke, HELIOS-Hospital Wuppertal, Wuppertal, Germany© 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byOrdorica R, Wiegand L, Webster J and Lockhart J (2018) Ureteral Replacement and Onlay Repair with Reconfigured Intestinal SegmentsJournal of Urology, VOL. 191, NO. 5, (1301-1306), Online publication date: 1-May-2014. Volume 187Issue 2February 2012Page: 542-548 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.Keywordscolonurinary diversionureterAcknowledgmentsAngela Haas provided line drawings.MetricsAuthor Information D.A. Lazica More articles by this author B. Ubrig More articles by this author A.S. Brandt More articles by this author F.C. von Rundstedt More articles by this author S. Roth More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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