title: Laparoscopic ureteral replacement by Boari flap: multi-institutional experience in 30 cases.
abstract: BACKGROUND
  The Boari flap is an excellent technique for replacement of distal ureteral injuries. There are few reports with the use of laparoscopic surgery, especially with long term results. Our goal is to present the results of a multi-institutional study of 30 cases.
  
  
  METHODS
  We analyzed 30 patients treated between December 2001 and January 2009 who underwent a laparoscopic intracorporeal Boari flap, in three Latin American centers. In all cases the same surgical technique was employed. The database was recorded prospectively and analyzed retrospectively.
  
  
  RESULTS
  The mean age was 43.2 years (range 9 to 71 years). Most were women (22 of 30) with a slight predominance of left-side lesions (17 of 30). The most common cause of ureteral injury was hysterectomy in 14 patients (46.6%) and endoscopic ureterolithotomy in 9 patients (30%). The mean length of ureteral resection was 7 cm. (5 to 20 cm). The average operative time was 161.16 min (90 to 280 min). The average estimated blood loss was 123 mL. (0 to 500 mL), and hospital stay was 4.86 days (2 to 10 days). There were no intraoperative complications or conversion to open surgery. Postoperative complications occurred in 5 patients (16.6%), Clavien 1 in 2 patients (6.6%) and Clavien 3 in three patients (10%). The success rate was 96.6% (29 patients) with a mean follow up of 32 months (5 to 60 months).
  
  
  CONCLUSIONS
  Laparoscopic Boari flap in our hands had good short and long term results.
authors.affiliation: Unidad de Urología y Centro de Cirugía Robótica, Clínica Indisa, Santiago, Chile; Facultad de Medicina, Universidad Andrés Bello, Santiago, Chile. Electronic address: octavio.castillo@indisa.cl.
authors.forename: O A
authors.initials: OA
authors.lastname: Castillo
authors.forename: J
authors.initials: J
authors.lastname: Travassos
authors.forename: F
authors.initials: F
authors.lastname: Escobar J
authors.forename: G
authors.initials: G
authors.lastname: Lopez-Fontana
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013524:Surgical Flaps; D014513:Ureter / Q000293:injuries / Q000601:surgery*; D001743:Urinary Bladder / Q000637:transplantation; D013520:Urologic Surgical Procedures / Q000379:methods; D055815:Young Adult
keywords: Boari; Laparoscopia; Laparoscopic; Lesión del uréter; Reemplazo ureteral; Ureter; Ureteral injury; Ureteral replacement; Uréter