[Ileal ureteric replacement for iatrogenic long segment ureteric injuries].
OBJECTIVE
To investigate the efficacy of ileal ureteric replacement in the treatment of iatrogenic long segment ureteric injuries.


METHODS
The hospital records of 9 cases with iatrogenic long segment ureteric injuries during Aug. 2010 to Sept. 2014 treated with ileal ureteric replacement were retrospectively reviewed and followed-up postoperatively. The patients included 3 males and 6 females with a median age of 40 years. The length of injury segment was 13-25 cm (median 20 cm). The etiology of the iatrogenic injury was urological surgery (n=6), gynecological surgery (n=2) and general surgery (n=1), respectively. The ureter stent was removed in 1-2 month postoperatively in all the 9 cases.


RESULTS
All the operations were successful. The operation time was 203-394 min, with the average of (278.1±68.8) min. The bleeding volume was 10-1 000 mL, with the median of 200 mL. The mean length of hospital stay was (16.8±7.5) days. Four minor complications (Grade I-II) developed, including 3 ileus (33.3%) and 1 proximal anastomotic leakage (11.1%). The median follow-up time was 11 months, serum creatinine decreased or remained stable in 8 patients (88.9%). Three patients (33.3%) developed mild hydronephrosis and short-time urinary tract infection was seen in 1 patient (11.1%). Metabolic acidosis was not detected during the follow-up.


CONCLUSIONS
Ileal ureteric replacement is a safe and effective method in patients with complex or difficult iatrogenic long segment ureteric injuries.
Department of Urology, Peking University First Hospital; Institute of Urology, Peking University; National Urological Cancer Center, Beijing 100034, China.
Pei
P
Liu
Department of Urology, Peking University First Hospital; Institute of Urology, Peking University; National Urological Cancer Center, Beijing 100034, China.
Xin
X
Wu
Department of Urology, Peking University First Hospital; Institute of Urology, Peking University; National Urological Cancer Center, Beijing 100034, China.
Yu-ze
YZ
Zhu
Department of Urology, Peking University First Hospital; Institute of Urology, Peking University; National Urological Cancer Center, Beijing 100034, China.
Qi
Q
Tang
Department of Urology, Peking University First Hospital; Institute of Urology, Peking University; National Urological Cancer Center, Beijing 100034, China.
Dong
D
Fang
Department of Urology, Peking University First Hospital; Institute of Urology, Peking University; National Urological Cancer Center, Beijing 100034, China.
Xue-song
XS
Li
Department of Urology, Peking University First Hospital; Institute of Urology, Peking University; National Urological Cancer Center, Beijing 100034, China.
Jin-rui
JR
Hao
Department of Urology, Peking University First Hospital; Institute of Urology, Peking University; National Urological Cancer Center, Beijing 100034, China.
Li-qun
LQ
Zhou
D000328:Adult; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects; D006801:Humans; D006869:Hydronephrosis; D007049:Iatrogenic Disease; D007677:Kidney Function Tests; D008297:Male; D012092:Replantation; D012189:Retrospective Studies; D015607:Stents; D014513:Ureter / Q000473:pathology / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000009:adverse effects