Castilló-Vela Ignacio, Del Pozo Jiménez Gema, Turo Antona Jorge, Vázquez Alba David, Sáenz Medina Javier, Carballido Rodríguez Joaquín
Servicio de Urología. Hospital Universitario Puerta de Hierro de Majadahonda. Madrid. España.
Arch Esp Urol. 2017 May;70(4):436-444.
To report our initial experience with laparoscopic Boari flap ureteral reimplantation and to review the main technical elements in ureteral reconstructive surgery.
In a 10-year period we performed 23 laparoscopic ureteral reimplantations. Three cases required a Boari flap. Two patients presented ureteral stenosis above the iliac vessels and the third one a urothelial tumor of the pelvic ureter.
Two cases were completed laparoscopically; the third one was electively converted to open surgery to avoid prolonged OR time. Mean operative time was 276 minutes (270-290 min). There were no intraoperative complications. Mean hospital stay was 6.6 days. One patient presented postoperative UTI (Clavien 2). One patient developed with history of sever arteriopathy and aortorenal by pass developed ureteral stenosis proximal to the ureteral reimplantation eight months after the operation.
Laparoscopic Boari flap ureteral reimplantation is an affective technique for ureteral reconstruction, safe and reproducible, reserved for cases of ureteral pathology in which the distance to bridge between the bladder and the ureteral stump is long.
报告我们在腹腔镜下Boari皮瓣输尿管再植术方面的初步经验，并回顾输尿管重建手术的主要技术要点。
在10年期间，我们进行了23例腹腔镜输尿管再植术。其中3例需要行Boari皮瓣手术。2例患者在髂血管上方出现输尿管狭窄，第3例患者患有盆腔段输尿管尿路上皮肿瘤。
2例通过腹腔镜完成手术；第3例为避免手术时间过长而选择转为开放手术。平均手术时间为276分钟（270 - 290分钟）。术中无并发症。平均住院时间为6.6天。1例患者术后发生尿路感染（Clavien 2级）。1例有严重动脉病变和主动脉肾旁路病史的患者在术后8个月，输尿管再植部位近端出现输尿管狭窄。
腹腔镜下Boari皮瓣输尿管再植术是一种有效的输尿管重建技术，安全且可重复，适用于膀胱与输尿管残端之间需要搭桥距离较长的输尿管病变病例。
