García-Escobar JC, Rosas-Nava JE, Jiménez-Cisneros E, Tena-González-Méndez G, Doria-Lozano MI, González-Bonilla EA, Téllez-Sánchez M, Maldonado-Ávila M, Soria-Fernández G, Garduño-Arteaga ML, Jaspersen-Gastelum J, Corona-Montes VE

Language: Spanish
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ABSTRACT

Objective: To present the results of our series of patients with lower third ureteral pathology, who underwent laparoscopic ureteral reimplantation in a tertiary care hospital.
Material and methods: A retrospective study that included 18 patients with lower third ureteral pathology, treated with laparoscopic ureteral reimplanta- tion, between July 2014 and December 2020. Demographic and clinical data, intraoperative results, complications, and days of hospital stay were collected, as well as postoperative control.
Results: Transperitoneal Lich-Gregoir laparoscopic ureteral reimplantation was performed in 18 patients with lower third ureteral pathology (6 men and 12 women, 8 cases with right laterality and 10 left). Etiology: (11) 61% post- surgical stenosis, (2) 11% ureterovaginal fistula; (3) 17% vesicoureteral reflux, and (2) 11% congenital stricture. All cases had preoperative imaging studies. The mean age was 38.7 years; transoperative time 152 minutes; intraoperative bleeding of 65 ml. There were no intraoperative complications; The average hospital stay was 2.5 days. In all cases, a double J ureteral catheter was placed, which was removed 4 to 6 weeks after surgery.
Conclusions: The laparoscopic ureteral reimplantation is a safe procedure for the treatment of lower third ureteral pathology. This modality seems to improve the profile of perioperative complications compared to the open ap- proach, maintaining long-term results. The laparoscopic approach shows a decrease in surgical time, less bleeding, and a lower rate of complications and hospital stay, however, laparoscopic skills and experience must be available to perform it.

REFERENCES

1. Xue R-Z, Tang Z-Y, Zeng M-Q, Huang L, Chen J-J, Chen Z. Two-stage laparoscopic repair of two-level ureteral strictures: our experience of 8 patients. Urol J. 2019 Feb 21;16(1):27–31. doi: https://doi.org/10.22037/uj.v0i0.4082

2. Li B-S, He Y, Chen Z, Wang Z-H, Wen Z-Q, ChenX. Transperitoneal Intravesical Technique for Laparoscopic Ureteral Reimplantation to Treat Terminal Ureteral Stenosis. J Laparoendosc Adv Surg Tech A. 2017 Jun;27(6):623–8. doi: https://doi.org/10.1089/lap.2016.0431

3. Seideman CA, Huckabay C, Smith KD, Permpongkosol S, Nadjafi-Semnani M, Lee BR, et al. Laparoscopic ureteral reimplantation: technique and outcomes. J Urol. 2009 Apr;181(4):1742–6. doi: https://doi.org/10.1016/j.juro.2008.11.102

4. Riquelme M, Lopez M, Landa S, Mejia F, Aranda A, Rodarte-Shade M, et al. Laparoscopic extravesical ureteral reimplantation (LEVUR):a multicenter experience with 95 cases. Eur J Pediatr Surg. 2013 Apr;23(2):143–7. doi: https://doi.org/10.1055/s-0032-1329708

5. Ochoa-Gibert Y, González-León T, Suárez- Marcillán ME, Bautista-Olivé J, Sánchez- Hernández EC. Laparoscopic ureteral reimplantation in surgical injuries of the lower ureter. RCU. 2015 Jul 6;4(1):15–22. [accessed8 Sep 2022] Available from: https://www. medigraphic.com/cgi-bin/new/resumenI. cgi?IDARTICULO=60156

6. Bustangi N, Kallas Chemaly A, Scalabre A, Khelif K, Luyckx S, Steyaert H, et al. Extravesical Ureteral Reimplantation Following Lich-Gregoir Technique for the Correction of Vesico-Ureteral Reflux Retrospective Comparative Study Open vs. Laparoscopy. Front Pediatr. 2018 Dec 18;6:388. [accessed 8 Sep 2022] Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/ PMC6305429/

7. Ghosh B, Jain P, Pal DK. Managing Mid and Lower Ureteral Benign Strictures: The Laparoscopic Way. J Laparoendosc Adv Surg Tech A. 2018 Jan;28(1):25–32. doi: https://doi. org/10.1089/lap.2017.0256

8. Zapata-González JA, Camacho-Castro JB, Reyna-Bulnes AI, García-Sánchez SM, Reyes-Verástegui F, Niño-Ortiz LE, et al. Ureteroneocistostomía con psoas Hitch laparoscópico como tratamiento de fístula ureterovaginal: experiencia inicial. Revista Mexicana de Urología. 2014 Jan 1;74(1):19–24. doi: https://doi.org/10.48193/revista mexicanadeurologa.v74i1.149

9. González Rodríguez I, Gil Ugarteburu R, Fernández-Pello S, Díaz Méndez B, Blanco Fernández R, Mosquera Madera J. [Laparoscopic ureteral reimplantation.]. Arch Esp Urol. 2017 May;70(4):412–21.

10. Farina A, Esposito C, Escolino M, Lopez M, Settimi A, Varlet F. Laparoscopic extravesical ureteral reimplantation (LEVUR): a systematic review. Transl Pediatr. 2016 Oct;5(4):291–4. doi: https://doi.org/10.21037/tp.2016.10.01

11. Symons S, Kurien A, Desai M. Laparoscopic ureteral reimplantation: a single center experience and literature review. J Endourol. 2009 Feb;23(2):269–74. doi: https://doi. org/10.1089/end.2008.0266

12. Slawin J, Patel NH, Lee Z, Dy GW, Kim D, Asghar A, et al. Ureteral Reimplantation via Robotic Nontransecting Side-to-Side Anastomosis for Distal Ureteral Stricture. J Endourol. 2020 Aug;34(8):836–9. doi: https:// doi.org/10.1089/end.2019.0877