Onlay Repair Technique for the Management of Ureteral Strictures: A Comprehensive Review
Ureteroplasty using onlay grafts or flaps emerged as an innovative procedure for the management of proximal and midureteral strictures. Autologous grafts or flaps used commonly in ureteroplasty include the oral mucosae, bladder mucosae, ileal mucosae, and appendiceal mucosae. Oral mucosa grafts, esp...
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doaj-71f12ac3ca78461894f8c4c8952239f62020-11-25T02:47:50ZengHindawi LimitedBioMed Research International2314-61332314-61412020-01-01202010.1155/2020/61782866178286Onlay Repair Technique for the Management of Ureteral Strictures: A Comprehensive ReviewShengwei Xiong0Jie Wang1Weijie Zhu2Kunlin Yang3Guangpu Ding4Xuesong Li5Daniel D. Eun6Department of Urology, Peking University First Hospital, No. 8 Xishiku St, Xicheng District, Beijing 100034, ChinaDepartment of Urology, Peking University First Hospital, No. 8 Xishiku St, Xicheng District, Beijing 100034, ChinaDepartment of Urology, Peking University First Hospital, No. 8 Xishiku St, Xicheng District, Beijing 100034, ChinaDepartment of Urology, Peking University First Hospital, No. 8 Xishiku St, Xicheng District, Beijing 100034, ChinaDepartment of Urology, Peking University First Hospital, No. 8 Xishiku St, Xicheng District, Beijing 100034, ChinaDepartment of Urology, Peking University First Hospital, No. 8 Xishiku St, Xicheng District, Beijing 100034, ChinaDepartment of Urology, Temple University School of Medicine, 255S 17th Street, 7th Floor Medical Tower, Philadelphia, PA 19103, USAUreteroplasty using onlay grafts or flaps emerged as an innovative procedure for the management of proximal and midureteral strictures. Autologous grafts or flaps used commonly in ureteroplasty include the oral mucosae, bladder mucosae, ileal mucosae, and appendiceal mucosae. Oral mucosa grafts, especially buccal mucosa grafts (BMGs), have gained wide acceptance as a graft choice for ureteroplasty. The reported length of BMG ureteroplasty ranged from 1.5 to 11 cm with success rates of 71.4%-100%. However, several studies have demonstrated that ureteroplasty using lingual mucosa grafts yields better recipient site outcomes and fewer donor site complications than that using BMGs. In addition, there is no essential difference in the efficacy and complication rates of BMG ureteroplasty using an anterior approach or a posterior approach. Intestinal graft or flap ureteroplasty was also reported. And the reported length of ileal or appendiceal flap ureteroplasty ranged from 1 to 8 cm with success rates of 75%-100%. Moreover, the bladder mucosa, renal pelvis wall, and penile/preputial skin have also been reported to be used for ureteroplasty and have achieved satisfactory outcomes, but each graft or flap has unique advantages and potential problems. Tissue engineering-based ureteroplasty through the implantation of patched scaffolds, such as the small intestine submucosa, with or without cell seeding, has induced successful ureteral regeneration structurally close to that of the native ureter and has resulted in good functional outcomes in animal models.http://dx.doi.org/10.1155/2020/6178286 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Shengwei Xiong Jie Wang Weijie Zhu Kunlin Yang Guangpu Ding Xuesong Li Daniel D. Eun |
spellingShingle |
Shengwei Xiong Jie Wang Weijie Zhu Kunlin Yang Guangpu Ding Xuesong Li Daniel D. Eun Onlay Repair Technique for the Management of Ureteral Strictures: A Comprehensive Review BioMed Research International |
author_facet |
Shengwei Xiong Jie Wang Weijie Zhu Kunlin Yang Guangpu Ding Xuesong Li Daniel D. Eun |
author_sort |
Shengwei Xiong |
title |
Onlay Repair Technique for the Management of Ureteral Strictures: A Comprehensive Review |
title_short |
Onlay Repair Technique for the Management of Ureteral Strictures: A Comprehensive Review |
title_full |
Onlay Repair Technique for the Management of Ureteral Strictures: A Comprehensive Review |
title_fullStr |
Onlay Repair Technique for the Management of Ureteral Strictures: A Comprehensive Review |
title_full_unstemmed |
Onlay Repair Technique for the Management of Ureteral Strictures: A Comprehensive Review |
title_sort |
onlay repair technique for the management of ureteral strictures: a comprehensive review |
publisher |
Hindawi Limited |
series |
BioMed Research International |
issn |
2314-6133 2314-6141 |
publishDate |
2020-01-01 |
description |
Ureteroplasty using onlay grafts or flaps emerged as an innovative procedure for the management of proximal and midureteral strictures. Autologous grafts or flaps used commonly in ureteroplasty include the oral mucosae, bladder mucosae, ileal mucosae, and appendiceal mucosae. Oral mucosa grafts, especially buccal mucosa grafts (BMGs), have gained wide acceptance as a graft choice for ureteroplasty. The reported length of BMG ureteroplasty ranged from 1.5 to 11 cm with success rates of 71.4%-100%. However, several studies have demonstrated that ureteroplasty using lingual mucosa grafts yields better recipient site outcomes and fewer donor site complications than that using BMGs. In addition, there is no essential difference in the efficacy and complication rates of BMG ureteroplasty using an anterior approach or a posterior approach. Intestinal graft or flap ureteroplasty was also reported. And the reported length of ileal or appendiceal flap ureteroplasty ranged from 1 to 8 cm with success rates of 75%-100%. Moreover, the bladder mucosa, renal pelvis wall, and penile/preputial skin have also been reported to be used for ureteroplasty and have achieved satisfactory outcomes, but each graft or flap has unique advantages and potential problems. Tissue engineering-based ureteroplasty through the implantation of patched scaffolds, such as the small intestine submucosa, with or without cell seeding, has induced successful ureteral regeneration structurally close to that of the native ureter and has resulted in good functional outcomes in animal models. |
url |
http://dx.doi.org/10.1155/2020/6178286 |
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