Three different laparoscopic techniques for the management of iatrogenic ureteral injury: A multi-institutional study with medium-term outcomes
Background: Excellent success rates with short-term outcomes are noted for laparoscopic ureteral reconstruction (LUR) for iatrogenic ureteral injury. This multi-institutional study assessed the medium-term (>1 year) outcomes and compared three surgical techniques of LUR. Methods: Patients who und...
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doaj-7a9d094a993f43658c96d636326593022021-07-09T04:42:10ZengElsevierAsian Journal of Surgery1015-95842021-07-01447964968Three different laparoscopic techniques for the management of iatrogenic ureteral injury: A multi-institutional study with medium-term outcomesTae Nam Kim0Jeong Ho Kim1Cheol Kyu Oh2Wan Lee3Jong Kil Nam4Ki Soo Lee5Department of Urology and Biomedical Research Institute, Pusan National University Hospital, Busan, South KoreaDepartment of Urology, Inje University Busan Paik Hospital, Busan, South KoreaDepartment of Urology, Inje University Busan Paik Hospital, Busan, South KoreaDepartment of Urology, Cancer Center, Dongnam Institute of Radiological & Medical Science, Busan, South KoreaDepartment of Urology, Yangsan Pusan National University Hospital, Yangsan, South KoreaDepartment of Urology, Dong-a University Hospital, Busan, South Korea; Corresponding author. Department of Urology, Dong-a University Hospital, 26 Daesingongwon-ro, Seo-gu, Busan, South Korea.Background: Excellent success rates with short-term outcomes are noted for laparoscopic ureteral reconstruction (LUR) for iatrogenic ureteral injury. This multi-institutional study assessed the medium-term (>1 year) outcomes and compared three surgical techniques of LUR. Methods: Patients who underwent LUR at five tertiary hospitals between January 2007 and June 2016 were retrospectively analyzed. Patients with active abdominopelvic inflammatory disease, history of urothelial cancer, and tumor recurrence and those who received adjuvant chemotherapy or radiotherapy were excluded. Results: The success rates of LUR for 61 patients at 3 months postoperatively and at the last follow-up (at least 12 months postoperatively) were 100% and 95.1%, respectively. No significant difference was noted in the success rates of the three types of LUR. LUR was mainly performed in response to the demands of the primary surgeon responsible for the iatrogenic injury (33 of 45 cases, 73.3%). The vesicoureteral reflux (VUR) incidence was higher in the refluxing laparoscopic ureteroneocystostomy (LUN) group (40%) than in the anti-refluxing LUN group (15%, odds ratio: 1.5, p = 0.252). None of the patients in the LUN groups received treatment for VUR during the follow-up. The laparoscopic end-to-end ureteroureterostomy (LEEU) group had shorter operative time (p < 0.001) and lesser intraoperative blood loss (p < 0.001) than the LUN groups. Conclusion: LUR is safe and feasible, with good medium-term outcomes. LEEU is a good surgical option in terms of the operative and subsequent outcomes. The anti-reflux technique in LUR reduces de-novo VUR development but is not necessary for preventing upper urinary tract infections in adults.http://www.sciencedirect.com/science/article/pii/S1015958421000683InjuriesLaparoscopyUreter |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Tae Nam Kim Jeong Ho Kim Cheol Kyu Oh Wan Lee Jong Kil Nam Ki Soo Lee |
spellingShingle |
Tae Nam Kim Jeong Ho Kim Cheol Kyu Oh Wan Lee Jong Kil Nam Ki Soo Lee Three different laparoscopic techniques for the management of iatrogenic ureteral injury: A multi-institutional study with medium-term outcomes Asian Journal of Surgery Injuries Laparoscopy Ureter |
author_facet |
Tae Nam Kim Jeong Ho Kim Cheol Kyu Oh Wan Lee Jong Kil Nam Ki Soo Lee |
author_sort |
Tae Nam Kim |
title |
Three different laparoscopic techniques for the management of iatrogenic ureteral injury: A multi-institutional study with medium-term outcomes |
title_short |
Three different laparoscopic techniques for the management of iatrogenic ureteral injury: A multi-institutional study with medium-term outcomes |
title_full |
Three different laparoscopic techniques for the management of iatrogenic ureteral injury: A multi-institutional study with medium-term outcomes |
title_fullStr |
Three different laparoscopic techniques for the management of iatrogenic ureteral injury: A multi-institutional study with medium-term outcomes |
title_full_unstemmed |
Three different laparoscopic techniques for the management of iatrogenic ureteral injury: A multi-institutional study with medium-term outcomes |
title_sort |
three different laparoscopic techniques for the management of iatrogenic ureteral injury: a multi-institutional study with medium-term outcomes |
publisher |
Elsevier |
series |
Asian Journal of Surgery |
issn |
1015-9584 |
publishDate |
2021-07-01 |
description |
Background: Excellent success rates with short-term outcomes are noted for laparoscopic ureteral reconstruction (LUR) for iatrogenic ureteral injury. This multi-institutional study assessed the medium-term (>1 year) outcomes and compared three surgical techniques of LUR. Methods: Patients who underwent LUR at five tertiary hospitals between January 2007 and June 2016 were retrospectively analyzed. Patients with active abdominopelvic inflammatory disease, history of urothelial cancer, and tumor recurrence and those who received adjuvant chemotherapy or radiotherapy were excluded. Results: The success rates of LUR for 61 patients at 3 months postoperatively and at the last follow-up (at least 12 months postoperatively) were 100% and 95.1%, respectively. No significant difference was noted in the success rates of the three types of LUR. LUR was mainly performed in response to the demands of the primary surgeon responsible for the iatrogenic injury (33 of 45 cases, 73.3%). The vesicoureteral reflux (VUR) incidence was higher in the refluxing laparoscopic ureteroneocystostomy (LUN) group (40%) than in the anti-refluxing LUN group (15%, odds ratio: 1.5, p = 0.252). None of the patients in the LUN groups received treatment for VUR during the follow-up. The laparoscopic end-to-end ureteroureterostomy (LEEU) group had shorter operative time (p < 0.001) and lesser intraoperative blood loss (p < 0.001) than the LUN groups. Conclusion: LUR is safe and feasible, with good medium-term outcomes. LEEU is a good surgical option in terms of the operative and subsequent outcomes. The anti-reflux technique in LUR reduces de-novo VUR development but is not necessary for preventing upper urinary tract infections in adults. |
topic |
Injuries Laparoscopy Ureter |
url |
http://www.sciencedirect.com/science/article/pii/S1015958421000683 |
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