Lich-Gregoir laparoscopic ureteral reimplantation in a third-level hospi-tal
DOI:
https://doi.org/10.48193/revistamexicanadeurologa.v82i4.765Keywords:
Laparoscopic ureteral reimplantation, vesicoureteral reflux, lower third ureteral pathology, double J catheterAbstract
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 reimplantation, 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% postsurgical 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 approach, 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
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
Li B-S, He Y, Chen Z, Wang Z-H, Wen Z-Q, Chen X. Transperitoneal Intravesical Technique for Laparoscopic Ureteral Reimplantation to Treat Terminal Ureteral Ste-nosis. J Laparoendosc Adv Surg Tech A. 2017 Jun;27(6):623–8. doi: https://doi.org/10.1089/lap.2016.0431
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
Riquelme M, Lopez M, Landa S, Mejia F, Aranda A, Rodarte-Shade M, et al. Laparo-scopic 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
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. [accessed 8 Sep 2022] Available from: https://www.medigraphic.com/cgi-bin/new/resumenI.cgi?IDARTICULO=60156
Bustangi N, Kallas Chemaly A, Scalabre A, Khelif K, Luyckx S, Steyaert H, et al. Extravesical Ureteral Reimplantation Following Lich-Gregoir Technique for the Cor-rection of Vesico-Ureteral Reflux Retrospective Comparative Study Open vs. Lapa-roscopy. Front Pediatr. 2018 Dec 18;6:388. [accessed 8 Sep 2022] Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6305429/
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
Zapata-González JA, Camacho-Castro JB, Reyna-Bulnes AI, García-Sánchez SM, Reyes-Verástegui F, Niño-Ortiz LE, et al. Ureteroneocistostomía con psoas Hitch la-paroscópico como tratamiento de fístula ureterovaginal: experiencia inicial. Revista Mexicana de Urología. 2014 Jan 1;74(1):19–24. [accessed 8 Sep 2022] Available from: https://www.sciencedirect.com/science/article/pii/S2007408515300057
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.
Farina A, Esposito C, Escolino M, Lopez M, Settimi A, Varlet F. Laparoscopic extra-vesical ureteral reimplantation (LEVUR): a systematic review. Transl Pediatr. 2016 Oct;5(4):291–4. doi: https://doi.org/10.21037/tp.2016.10.01
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
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
