Nasef Ahmed Salah, Tagrida Ibrahim Alaa Eldin, Salman Mohamed Fawzy, Elatreisy Adel, Khaled Sabry Mahmoud
Urology Department, Faculty of Medicine, Al-Azhar University, Cairo.
Arch Ital Urol Androl. 2025 Jun 30;97(2):13695. doi: 10.4081/aiua.2025.13695. Epub 2025 May 15.
To evaluate the outcomes of oral buccal mucosa graft (BMG) ureteroplasty in managing recurrent long-segment proximal ureteric strictures and recurrent uretero-pelvic junction obstruction (UPJO).
A single-centre prospective study included patients with recurrent long-segment proximal ureteric strictures and recurrent UPJO treated with open onlay BMG ureteroplasty from January 2022 to September 2024. Patient demographics, intraoperative and postoperative characteristics, and the percentage of stricture-free status at the last visit were documented. Complication rates were categorized according to the modified Clavien-Dindo grading system Results: The study included 21 patients, 11 males (52.4%) and 10 females (47.6%), with a mean age ± SD of 45.8 ± 13.7 years. Regarding the stricture etiology, Ten patients (47.6%) had previously undergone complicated endoscopic stone surgeries, seven patients (33.3%) had a history of open surgery for stone disease, while the remaining four (19%) had undergone previously failed pyeloplasty for congenital UPJO. The mean operative time was 145 minutes, the mean stricture length ±SD was 3.94±1.4 cm, and the mean harvested BMG length ±SD was 7.6±1.1 cm. Six patients (28.6%) developed postoperative complications of Clavien II and III grade. The follow-up duration ranged from 9 to 24 months, with a mean duration of 16.3 months. At the last follow-up visit, 18 out of 21 patients (85.7%) were stricture-free.
Buccal mucosa graft for onlay ureteroplasty represents an effective surgical intervention for managing recurrent, long-segment proximal ureteric strictures and recurrent cases of ureteropelvic junction obstruction.
评估口腔颊黏膜移植（BMG）输尿管成形术治疗复发性长节段近端输尿管狭窄和复发性输尿管肾盂连接部梗阻（UPJO）的疗效。
一项单中心前瞻性研究纳入了2022年1月至2024年9月期间接受开放性覆盖式BMG输尿管成形术治疗的复发性长节段近端输尿管狭窄和复发性UPJO患者。记录患者的人口统计学资料、术中和术后特征以及最后一次随访时无狭窄状态的百分比。根据改良的Clavien-Dindo分级系统对并发症发生率进行分类。结果：该研究纳入了21例患者，其中男性11例（52.4%），女性10例（47.6%），平均年龄±标准差为45.8±13.7岁。关于狭窄病因，10例患者（47.6%）先前接受过复杂的内镜结石手术，7例患者（33.3%）有结石病开放手术史，其余4例（19%）先前因先天性UPJO接受肾盂成形术失败。平均手术时间为145分钟，平均狭窄长度±标准差为3.94±1.4厘米，平均采集的BMG长度±标准差为7.6±1.1厘米。6例患者（28.6%）发生了Clavien II级和III级术后并发症。随访时间为9至24个月，平均时间为16.3个月。在最后一次随访时，21例患者中有18例（85.7%）无狭窄。
颊黏膜移植输尿管成形术是治疗复发性长节段近端输尿管狭窄和复发性输尿管肾盂连接部梗阻的有效手术干预方法。
