| Ureteral stricture(US)is the narrowing of the ureteral lumen due to various reasons,and the flow of urine is blocked,which can cause hydroureter and/or hydronephrosis of different degrees above the stricture,which can lead to urinary system Serious complications such as infection,urinary calculus,bacteremia,sepsis,renal insufficiency and renal failure.Therefore,once it is discovered clinically,it needs to be treated in time.The treatment of ureteral stricture should be determined according to the cause,location and degree of stricture.The principle of treatment is to relieve the obstruction as soon as possible,prevent and control infection,and protect renal function.The methods of relieving obstruction include placement of ureteral catheter and percutaneous nephrostomy.After the acute obstruction is relieved,the final treatment plan will be determined according to the cause of the stenosis.Common clinical endoscopic surgical treatment methods include: balloon dilatation,internal ureterotomy,Allium coated metal ureteral stent expansion;ureteral reconstruction surgery methods include: ureteroureter anastomosis,ureteropelvic anastomosis,ureterovesical anastomo-sis,intestinal replacement ureter,appendix replacement ureter,oral mucosa replaceme-nt ureter,and emerging technology ureteral tissue engineering,etc.Since the treatment of ureteral stenosis often requires different treatment options depending on the location,length,and degree of stenosis,and there is no recognized guideline for the treatment of ureteral stenosis at home and abroad.Since Simonato applied lingual mucosal grafts to urethroplasty in 2006,more and more surgeons have reported successful use of BMG or LMG for ureteral strictures.reconstruction.In view of the good curative effect of oral mucosal repair of ureters reported by domestic and foreign studies,and the increasing maturity of laparoscopic technology in our department,this article discusses the laparoscopic lingual mucosal transplantation of ureters in the Urology Department of Jingzhou Hospital Affiliated to Yangtze University from October 2020 to March2023.The clinical curative effect of 7 cases of ureteral stricture treated by plastic surgery was studied.Objective: To study the clinical effect of laparoscopic lingual mucosa transplantation ureteroplasty in the treatment of long stenosis of upper ureter.Methods: From October 2020 to March 2023,7 patients with ureteral stenosis who received this operation in the Urology Department of Jingzhou Hospital Affiliated to Yangtze University were included in the study,and the hydronephrosis,hydronephrosis,The degree of ureteral stenosis,renal function(GFR),operation time,postoperative complications and other clinical data were used to study the clinical efficacy of this operation.Results: In this study,all 7 patients successfully completed laparoscopic tongue mucosal transplantation ureteroplasty.The average age of the patients was 39.29(15～56)years,the average stenosis length was 5.07(3.5～6)cm,the average operation time was 260(240～300)min,the average intraoperative blood loss was 80(60～100)ml,the average indwelling catheterization time was 9.29(7～12)d,the average indwelling double J tube time was 7.29(6～8)w,the average preoperative hydronephrosis was5.79(4～8)cm,the average postoperative hydronephrosis was 2.81(0.7～3.5)cm,and the average preoperative GFR107.5(80 ～ 125)ml/min,average postoperative GFR113.29(81～132)ml/min.After the removal of the double J tube,renal ureteral ultrasound,renal ureteral CT and GFR showed significant improvement in hydronephrosis and GFR.IVP shows no stenosis at the anastomosis between the ureter and tongue mucosa,and no contrast extravasation.The patient did not experience low back pain,fever,gross hematuria and other discomforts after surgery.Conclusion: Postoperative reexamination and follow-up showed that this operation method is a new,effective and safe method for treating long-segment stenosis of upper ureter. |
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