Department of Urology, Ludwig Maximilians University, Munich, Germany.
Department of Urology, Loretto Hospital, Freiburg, Germany.
Investig Clin Urol. 2020 May;61(3):316-322. doi: 10.4111/icu.2020.61.3.316. Epub 2020 Mar 9.
To report a single surgeon experience with one year follow-up after open ureteroplasty with buccal mucosa graft (OUBMG) in the rare situation of long segment proximal ureteral strictures.
Four patients with long segment proximal ureteral stricture underwent OU-BMG between February and July 2017. Functional outcome was assessed by pre- and postoperative serum creatinine, ultrasound and renal scintigraphy as well as patient reported outcomes.
Four patients with an average stricture length of 4 cm underwent OU-BMG between February and July 2017. No major postoperative complications occurred. Retrograde uretero-pyelography 6 weeks postoperatively revealed a watertight anastomosis followed by immediate emptying of the renal pelvis and ureter in all four patients. Ureteroscopy at this time showed a wide lumen with well-vascularized pink mucosa. After a mean follow-up time of 12.5 (12-14) months, postoperative serum creatinine was unimpaired. Renal scintigraphy revealed no signs of renal obstruction. With regard to intraoral surgery, no difficulties with mouth opening or intraoral dryness or numbness were reported.
For patients with long segment ureteral strictures OU-BMG is a safe technique with excellent surgical and functional outcomes. Hence, the application of this technique should be encouraged and regarded as one of the standard options in case of this rare problem.
报告一位外科医生在罕见的长段近端输尿管狭窄情况下，采用口腔颊黏膜移植（OUBMG）进行开放输尿管成形术的一年随访经验。
2017 年 2 月至 7 月期间，4 例长段近端输尿管狭窄患者接受 OUBMG。通过术前和术后血清肌酐、超声和肾闪烁扫描以及患者报告的结果来评估功能结果。
4 例平均狭窄长度为 4cm 的患者在 2017 年 2 月至 7 月期间接受了 OUBMG。无重大术后并发症发生。术后 6 周逆行输尿管肾盂造影显示吻合口严密，所有 4 例患者肾盂和输尿管立即排空。此时输尿管镜检查显示管腔宽大，黏膜呈粉红色，血管丰富。平均随访 12.5 个月（12-14 个月）后，术后血清肌酐未受损。肾闪烁扫描显示无肾梗阻迹象。关于口腔内手术，无张口困难、口腔干燥或麻木报告。
对于长段输尿管狭窄患者，OUBMG 是一种安全的技术，具有出色的手术和功能结果。因此，应鼓励应用该技术，并将其视为这种罕见问题的标准选择之一。
