Shimizu Nobuhiko, Naya Yukio, Sekine Keita, Hou Kyokushin, Okato Atsushi, Suyama Takahito, Araki Kazuhiro, Masuda Hiroshi, Kojima Satoko
Department of Urology Teikyo University Chiba Medical Center Ichihara Chiba Japan.
IJU Case Rep. 2022 Dec 19;6(2):124-127. doi: 10.1002/iju5.12567. eCollection 2023 Mar.
Redo pyeloplasty can be difficult due to scar tissue or fibrosis. Ureteral reconstruction with a buccal mucosal graft is performed safely and successfully, but most reports of ureteral reconstruction using a buccal mucosal graft are of robot-assisted surgery, with few reports of laparoscopic-assisted surgery. A case of laparoscopic-assisted redo pyeloplasty using a buccal mucosal graft is presented.
A 53-year-old woman was diagnosed with ureteropelvic junction obstruction, and a double-J stent was placed to relieve backache. She visited our hospital 6 months after double-J stent placement. Three months later, laparoscopic pyeloplasty was performed. At 2 months postoperatively, anatomic stenosis occurred. Holmium laser endoureterotomy and balloon dilation were performed; however, the anatomic stenosis recurred, and laparoscopic redo pyeloplasty with a buccal mucosal graft was performed. After redo pyeloplasty, obstruction was improved, and her symptoms disappeared.
This is the first case of using a buccal mucosal graft for laparoscopic pyeloplasty in Japan.
由于瘢痕组织或纤维化，再次肾盂成形术可能具有挑战性。使用颊黏膜移植物进行输尿管重建安全且成功，但大多数关于使用颊黏膜移植物进行输尿管重建的报道是机器人辅助手术，腹腔镜辅助手术的报道较少。本文介绍了一例使用颊黏膜移植物的腹腔镜辅助再次肾盂成形术病例。
一名53岁女性被诊断为肾盂输尿管连接部梗阻，并置入双J支架以缓解背痛。双J支架置入6个月后她前来我院就诊。3个月后，进行了腹腔镜肾盂成形术。术后2个月出现解剖性狭窄。进行了钬激光输尿管内切开术和球囊扩张术；然而，解剖性狭窄复发，遂进行了使用颊黏膜移植物的腹腔镜再次肾盂成形术。再次肾盂成形术后，梗阻情况得到改善，症状消失。
这是日本首例使用颊黏膜移植物进行腹腔镜肾盂成形术的病例。
