Laparoscopic ileal ureteral reconstruction

Al-Attar T.H., Pirozhok Y.S., Shestykh A.V., Komyakova E.B., Gavrilov V.Y.

Department of Urology (headed by Professor B.K. Komyakov) of the North-Western State Medical University named after I.I. Mechnikov, Saint-Petersburg, Russia

Restoration of urinary tract continuity using isolated segments of the small intestine is required in cases of extensive ureteral defects of various origins. In recent years, several publications have reported the use of laparoscopic techniques for performing ileoureteroplasty. The aim of the research is to present the outcomes of laparoscopic intestinal ureteral reconstruction.
Materials and methods. From 2001 to 2026, small bowel ureteral reconstruction was performed in 249 patients. Laparoscopic ileoureteroplasty has been carried out by our team since 2013, and during this period we have accumulated experience with 101 such operations (50.2%), involving a total of 109 ureters. Among these patients, there were 44 men (43.6%) and 57 women (56.4%), with a mean age of 48.8±1.6 years. Unilateral ileoureteroplasty was performed in 93 patients (92.1%), and bilateral procedures in 8 patients (7.9%).
Results. Early postoperative complications occurred in 6 patients (5.9%). There were no fatal outcomes. Late complications were followed up in 89 patients over a period ranging from 3 to 254 months (mean 66±2 months) after surgery and developed in 5 patients (5.6%). Urinary tract urodynamics on the operated side improved in all patients. According to nephroscintigraphy, kidney function after ileoureteroplasty improved in 98 patients (97.0%), remained at the same level in 1 (1.0%) and worsened in 2 (2.0%) patients.
Discussion. An isolated segment of the ileum is the best and most versatile substitute for the reconstruction of extensive ureteral defects. In most patients, ileoureteroplasty can be successfully performed using a laparoscopic approach.
Conclusion. Laparoscopic ileoureteroplasty reduces surgical trauma and shortens the duration of hospital stay.

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About the Authors

Corresponding author: T.H. Al-Attar – Doctor of Medical Science (DMSc), Professor of the Department of Urology of the North-Western State Medical University named after I.I. Mechnikov, Saint-Petersburg, Russia; e-mail: dr-talat@mail.ru

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