Yang Kunlin, Fan Shubo, Li Zhihua, Guan Hua, Zhang Peng, Li Xuesong, Zhou Liqun
Department of Urology, Peking University First Hospital, Beijing, China; Institute of Urology, Peking University, Beijing, China; National Urological Cancer Center, Beijing, China.
Department of Urology, Emergency General Hospital, Beijing, China.
Ann Palliat Med. 2021 Apr;10(4):4840-4845. doi: 10.21037/apm-20-2339. Epub 2021 Mar 23.
Long proximal or middle ureteral strictures remain challenging conditions. Although ileal replacement of the ureter or renal autotransplantation are possible solutions for these problems, both present complexities and considerable morbidity. In recent years, many urologists have tended to use oral mucosal grafts to repair complex proximal or middle ureteral strictures and thereby avoid ileal replacement and renal autotransplantation. A comprehensive search of oral mucosa graft ureteroplasty and lingual mucosa graft (LMG) ureteroplasty was performed. All literatures must be in English language. Most reports related to oral mucosa graft ureteroplasty focus on buccal mucosa grafts (BMGs). The available data about LMG ureteroplasty are limited. Both LMG and BMG are oral mucosa grafts that have similar histological structures. The success rates of urethroplasty with LMG and BMG are similar. Although there is still no comparative study between LMG and BMG for ureteroplasty, the limited reports show that LMG ureteroplasty is safe and effective for the management of ureteral strictures. This method provides one more option for the management of long proximal and/or middle ureteral strictures. However, the current studies on LMG ureteroplasty have a small sample size and are retrospective. More prospective, multicenter and large sample studies with long-term follow-up results that can further prove the efficacy of LMG ureteroplasty are still needed.
较长的近端或中段输尿管狭窄仍然是具有挑战性的病症。尽管输尿管回肠代换术或自体肾移植术是解决这些问题的可行办法，但两者都存在复杂性且发病率较高。近年来，许多泌尿外科医生倾向于使用口腔黏膜移植物来修复复杂的近端或中段输尿管狭窄，从而避免输尿管回肠代换术和自体肾移植术。我们对口腔黏膜移植物输尿管成形术和舌黏膜移植物（LMG）输尿管成形术进行了全面检索。所有文献必须为英文。大多数与口腔黏膜移植物输尿管成形术相关的报告都集中在颊黏膜移植物（BMG）上。关于LMG输尿管成形术的现有数据有限。LMG和BMG均为具有相似组织结构的口腔黏膜移植物。LMG和BMG用于尿道成形术的成功率相似。尽管目前尚无LMG和BMG用于输尿管成形术的比较研究，但有限的报告表明，LMG输尿管成形术治疗输尿管狭窄是安全有效的。该方法为治疗较长的近端和/或中段输尿管狭窄提供了又一种选择。然而，目前关于LMG输尿管成形术的研究样本量较小且为回顾性研究。仍需要更多前瞻性、多中心且具有长期随访结果的大样本研究，以进一步证实LMG输尿管成形术的疗效。
