title: The use of transureteroureterostomy during ureteral reconstruction for advanced primary or recurrent pelvic malignancy in the era of multimodal therapy.
abstract: OBJECTIVE
  Cancerous involvement of a ureter is sometimes encountered in pelvic surgery for malignancy. We usually perform transureteroureterostomy (TUU) in cases of unilateral lower ureteral cancerous involvement. We report the outcomes in patients treated with TUU in our institute.
  
  
  METHODS
  We retrospectively reviewed the medical records of 11 patients who underwent TUU between June 2006 and September 2015.
  
  
  RESULTS
  The primary disease was colon cancer in five patients, rectal cancer in four, and uterine cervical cancer and ovarian cancer in one patient each. Early postoperative complications relevant to TUU occurred in four patients; however, three patients were managed conservatively and recovered quickly. Only one patient developed ureteral obstruction, which resulted from anastomotic hematoma. Follow-up periods ranged from 5 to 78 months with a median of 28 months. The median estimated glomerular filtration rate before and after TUU was 59 ml/min (range, 31-90 ml/min) and 62.0 ml/min (range, 43-127 mL/min), respectively. No patients experienced worsening of their renal function or recurrent urinary tract infection.
  
  
  CONCLUSIONS
  Short-term outcomes are good and long-term renal function is maintained following TUU. TUU is considered a feasible technique for ureteral reconstruction for pelvic malignancy, and TUU has great potential in the era of multimodal therapy.
authors.affiliation: Department of Surgery, Shiga Medical Center for Adults, 5-4-30 Moriyama, Moriyama, Shiga, 524-8524, Japan. kawamura@kuhp.kyoto-u.ac.jp.|Department of Surgery, Faculty of Medicine, Kindai University, 377-2 Ohno Higashi, Osaka Sayama, Osaka, 589-8511, Japan. kawamura@kuhp.kyoto-u.ac.jp.
authors.forename: Junichiro
authors.initials: J
authors.lastname: Kawamura
authors.affiliation: Department of Surgery, Shiga Medical Center for Adults, 5-4-30 Moriyama, Moriyama, Shiga, 524-8524, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Tani
authors.affiliation: Department of Surgery, Shiga Medical Center for Adults, 5-4-30 Moriyama, Moriyama, Shiga, 524-8524, Japan.
authors.forename: Kimiaki
authors.initials: K
authors.lastname: Sumida
authors.affiliation: Department of Surgery, Shiga Medical Center for Adults, 5-4-30 Moriyama, Moriyama, Shiga, 524-8524, Japan.
authors.forename: Takefumi
authors.initials: T
authors.lastname: Yazawa
authors.affiliation: Department of Surgery, Shiga Medical Center for Adults, 5-4-30 Moriyama, Moriyama, Shiga, 524-8524, Japan.
authors.forename: Junya
authors.initials: J
authors.lastname: Kawasoe
authors.affiliation: Department of Surgery, Shiga Medical Center for Adults, 5-4-30 Moriyama, Moriyama, Shiga, 524-8524, Japan.
authors.forename: Michihiro
authors.initials: M
authors.lastname: Yamamoto
authors.affiliation: Department of Surgery, Shiga Medical Center for Adults, 5-4-30 Moriyama, Moriyama, Shiga, 524-8524, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Harada
authors.affiliation: Department of Surgery, Shiga Medical Center for Adults, 5-4-30 Moriyama, Moriyama, Shiga, 524-8524, Japan.
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Yamamoto
authors.affiliation: Department of Surgery, Shiga Medical Center for Adults, 5-4-30 Moriyama, Moriyama, Shiga, 524-8524, Japan.
authors.forename: Masazumi
authors.initials: M
authors.lastname: Zaima
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D010386:Pelvic Neoplasms / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D014513:Ureter / Q000601:surgery*; D014519:Ureterostomy
keywords: Colorectal neoplasms; Pelvic malignancy; Transureteroureterostomy; Ureteral reconstruction