Transureteroureterostomy: an adjunct to the management of advanced primary and recurrent pelvic malignancy.
OBJECTIVE
The surgical management of advanced primary or recurrent rectal cancer may involve the lower ureter or ureterovesical junction. With unilateral involvement, reconstruction of the ureters with salvage of the ipsilateral renal function should be considered.


METHODS
With optimal exposure both ureters are visualized. The crossed ureter is incised perpendicularly and then longitudinally on its medial aspect. An anterolateral ureterotomy is made on the recipient ureter. A mucosa-to-mucosa anastomosis is completed. Stents are used selectively.


RESULTS
Eleven patients with advanced pelvic malignancy underwent this procedure. There was one major complication requiring ureteronephrectomy of the crossed system.


CONCLUSIONS
Transureteroureterostomy should be considered as a treatment option in patients with unilateral ureteral obstruction.
Sugarbaker
Paul H
PH
Washington Cancer Institute, 110 Irving St. NW, Washington, DC 20010, USA. Paul.Sugarbaker@medstar.net
Gutman
Mordechai
M
Verghese
Mohan
M
D000328:Adult; D000714:Anastomosis, Surgical; D019468:Disease Management; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007682:Kidney Pelvis / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000601:surgery; D018365:Neoplasm, Residual; D009378:Neoplasms, Multiple Primary / Q000401:mortality / Q000601:surgery; D010386:Pelvic Neoplasms / Q000401:mortality / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality / Q000601:surgery; D012004:Rectal Neoplasms / Q000401:mortality / Q000601:surgery; D012086:Reoperation; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014513:Ureter / Q000601:surgery; D014519:Ureterostomy / Q000379:methods*