Velan Mukkani, Krishnan S Venkata, Ramesh Ajay, Jain Nitesh, Bafna Sandeep
Urology, Apollo Hospitals, Chennai, IND.
General Surgery, Saveetha Medical College and Hospital, Chennai, IND.
Cureus. 2025 Jun 19;17(6):e86387. doi: 10.7759/cureus.86387. eCollection 2025 Jun.
Buccal mucosal graft (BMG) ureteroplasty is a well-established technique for complex upper ureteric strictures, particularly with robotic assistance. However, limited guidance exists for cases involving a narrow ureteral plate. We present a novel technique employing a non-transecting mucosa-to-mucosa anastomosis at the stricture site, followed by BMG augmentation. This method adapts the principles of non-transecting urethroplasty (mucosal-sparing augmented non-transected anastomotic (MsANTA)) to the ureter, aiming to preserve vascularity. Patients underwent preoperative CT urography and intraoperative retrograde studies to delineate the stricture. After harvesting the buccal graft and identifying the narrow ureteral plate, mucosal approximation without transection was performed to widen the lumen, followed by watertight graft anastomosis. This vascular-preserving modification may reduce stricture recurrence. Further comparative studies are warranted to validate its efficacy.
颊黏膜移植输尿管成形术是一种用于复杂上段输尿管狭窄的成熟技术，尤其是在机器人辅助下。然而，对于涉及狭窄输尿管板的病例，指导有限。我们提出一种新技术，即在狭窄部位采用非横断性黏膜对黏膜吻合术，随后进行颊黏膜移植增强术。该方法将非横断性尿道成形术（保留黏膜增强非横断吻合术（MsANTA））的原则应用于输尿管，旨在保留血供。患者术前行CT尿路造影和术中逆行检查以明确狭窄情况。获取颊黏膜移植物并确定狭窄输尿管板后，进行非横断性黏膜对合以扩大管腔，随后进行严密的移植物吻合。这种保留血供的改良方法可能会减少狭窄复发。有必要进行进一步的对比研究以验证其疗效。
