title: Intestinal seromuscular tunneling: a novel method for ureteral replacement--an experimental design.
abstract: BACKGROUND
  Long-segment ureteral injuries may have different etiologies. Although multiple procedures have been previously used for ureteral replacement, none of them had optimum results, and replacement of long segments of injured ureter is still a challenging surgical problem. In this article, we have hypothesized that it may be possible to use intestinal seromuscular tunneling as a novel method for ureteral replacement.
  
  
  METHODS
  This experimental study was conducted on eight dogs. After cutting the ureter at about its mid-part and ligating the distal part, a 10-cm tunnel was made in the seromuscular layer of small intestine using a metallic probe, and a catheter was passed through it. Proximal and distal ends of the tunnel were anastomosed to proximal end of ureter and urinary bladder, respectively. After 8 weeks, the dogs were killed, and their whole urinary system was sent for histopathologic examinations.
  
  
  RESULTS
  No complication was noted during the post-op period. Histopathologic examinations confirmed that the seromuscular tunnel was well patent, lined by pseudostratified transitional epithelium and without any inflammatory reaction.
  
  
  CONCLUSIONS
  Our study shows that ureteral replacement by intestinal seromuscular tunneling is anatomically possible at least in animal model. However, more well-designed prospective studies are needed to confirm its long-term functional results.
authors.affiliation: General Surgery Department, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Hossein
authors.initials: H
authors.lastname: Hodjati
authors.forename: Jalal Khalili
authors.initials: JK
authors.lastname: Paidar
authors.forename: Perikala Vijayananda
authors.initials: PV
authors.lastname: Kumar
authors.forename: Hamed Ghoddusi
authors.initials: HG
authors.lastname: Johari
mesh_terms: D000818:Animals; D004285:Dogs; D007082:Ileum / Q000637:transplantation*; D007413:Intestinal Mucosa / Q000637:transplantation*; D011446:Prospective Studies; D014513:Ureter / Q000293:injuries / Q000601:surgery*; D014515:Ureteral Diseases / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods*