title: A new treatment for retroperitoneal fibrosis: initial experiences of using Seprafilm® to wrap the ureter.
abstract: OBJECTIVE
  To confirm the efficacy of using Seprafilm® (Genzyme Corp., Cambridge, MA, USA) for wrapping the ureter to treat the ureteric stenosis caused by retroperitoneal fibrosis (RPF).
  
  
  METHODS
  Between August 2010 and September 2012, 11 ureters in eight patients with RPF (seven males and one female, mean age 65 years) were treated. The mean (range) length of the narrow segment of the ureter was 30 (10-90) mm. During surgery, after having been released from adhesive tissue, the stenotic segment of the ureter was wrapped with Seprafilm to isolate it from the surrounding tissue. A radiographic follow-up was performed every 6 months using computed tomography, i.v. pyelography and/or (99m) Tc-mercapto-acetylglycyl-glycyl-glycine ((99m) Tc-MAG3) renal scintigraphy.
  
  
  RESULTS
  For the unilateral operations, the mean estimated blood loss was 39 mL, and the mean operating time was 154 min. All ureters were isolated from the fibrotic tissue and wrapped with Seprafilm successfully without major complications. During the mean follow-up period of 17 months, no ureteric restenoses were observed in the affected sides, but new stenosis occurred in the contralateral side of the ureter in one patient.
  
  
  CONCLUSIONS
  Although the follow-up period is still limited, we believe that the use of Seprafilm has the potential to become an effective option in the treatment of ureteric stenosis caused by RPF, when the omentum cannot be used. To establish the relative advantages of using Seprafilm over performing a standard omental wrap, further experimentation will be required to compare the two techniques.
authors.affiliation: Department of Urology, Komaki City Hospital, Komaki, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Kamihira
authors.forename: Tsuyoki
authors.initials: T
authors.lastname: Hirabayashi
authors.forename: Asaomi
authors.initials: A
authors.lastname: Yamaguchi
authors.forename: Hiroki
authors.initials: H
authors.lastname: Hirabayashi
authors.forename: Yoshie
authors.initials: Y
authors.lastname: Moriya
authors.forename: Akitoshi
authors.initials: A
authors.lastname: Fukatsu
authors.forename: Yoko
authors.initials: Y
authors.lastname: Yoshikawa
authors.forename: Osamu
authors.initials: O
authors.lastname: Matsuura
authors.forename: Kyosuke
authors.initials: K
authors.lastname: Kimura
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D012185:Retroperitoneal Fibrosis / Q000150:complications* / Q000628:therapy; D016896:Treatment Outcome; D014517:Ureteral Obstruction / Q000209:etiology / Q000473:pathology / Q000628:therapy*
chemical_list: C118198:Seprafilm; D006820:Hyaluronic Acid
keywords: retroperitoneal fibrosis (RPF); seprafilm®; surgical treatment; ureteral stenosis