[Substitutive non-modeled uretero-ileoplasty].

OBJECTIVES

To evaluate the indications and results of replacement uretero-ileoplasties performed over the last six years.

MATERIAL AND METHODS

Over a period of 6 years, 8 patients underwent subtotal or total replacement uretero-ileoplasty involving a total of 9 renal units. Preoperative temporary urinary diversion was performed in each patient. The mean preoperative serum creatinine was 88 mumol/l (range: 53 to 150). Uretero-ileoplasty was performed for ureteric stricture in 7 cases (bilateral in one case and in a solitary kidney in one case), ureteric necrosis following renal transplantation without a donor ureter in one case and urothelial tumour on a solitary kidney in one case.

RESULTS

The mean follow-up was 54 months. The mean operating time was 218 minutes for uretero-unilateral ileoplasties, with a mean length of hospital stay of 12 days (range: 10 to 18 days). The following complications were observed: acute urinary retention, stenosis of the ileo-vesical implantation treated by endoscopic dilatation, 2 incisional hernias after midline laparotomy, one case of stones of the ileo-vesical anastomosis, non-febrile urinary tract infections treated on an outpatient basis. The functional result was considered to be satisfactory in every case. No electrolyte disorders were observed. Mean postoperative serum creatinine was 86 mumol/l (range: 59 to 140).

CONCLUSION

In this recent series with a mean follow-up of 4.5 years, replacement uretero-ileoplasty successfully treated partial or total complex ureteric lesions with a low morbidity.