Sugarbaker Paul H, Gutman Mordechai, Verghese Mohan
Washington Cancer Institute, 110 Irving St. NW, Washington, DC 20010, USA.
Int J Colorectal Dis. 2003 Jan;18(1):40-4. doi: 10.1007/s00384-002-0399-2. Epub 2002 May 8.
The surgical management of advanced primary or recurrent rectal cancer may involve the lower ureter or ureterovesical junction. With unilateral involvement, reconstruction of the ureters with salvage of the ipsilateral renal function should be considered.
With optimal exposure both ureters are visualized. The crossed ureter is incised perpendicularly and then longitudinally on its medial aspect. An anterolateral ureterotomy is made on the recipient ureter. A mucosa-to-mucosa anastomosis is completed. Stents are used selectively.
Eleven patients with advanced pelvic malignancy underwent this procedure. There was one major complication requiring ureteronephrectomy of the crossed system.
Transureteroureterostomy should be considered as a treatment option in patients with unilateral ureteral obstruction.
