Lingual mucosal graft ureteroplasty for long (≥5 cm) proximal ureteral stricture: a multi-institutional 8-year experience
10.3760/cma.j.cn112139-20250630-00328
- VernacularTitle:自体舌黏膜补片修复超长段（≥5 cm）输尿管狭窄的多中心8年结果分析
- Author:
Xingyuan XIAO
1
;
Shuaishuai CHAI
;
Jinmin ZENG
;
Xincheng GAO
;
Kangxiang XU
;
Yuancheng ZHOU
;
Jianjun FANG
;
Qiuxuan YU
;
Wang WANG
;
Manshun DONG
;
Ruoyu LI
;
Mingzhe TANG
;
Junwei HU
;
Gong CHENG
;
Yujie XU
;
Dongyang ZENG
;
Chaoqi LIANG
;
Xuejun ZHANG
;
Yixiang LIAO
;
Bing LI
Author Information
1. 武汉大学中南医院泌尿外科 泌尿系统疾病湖北省重点实验室 武汉大学泌尿外科研究所，武汉 430071
- Publication Type:Journal Article
- Keywords:
Ureteral diseases;
Lingual mucosal graft;
Ureteroplasty;
Ureteral stricture;
Laparoscopic surgery;
Robot-assisted surgery
- From:
Chinese Journal of Surgery
2025;63(12):1104-1110
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the long-term effectiveness of lingual mucosal graft ureteroplasty (LMGU) for managing long-segment (≥5 cm) ureteral strictures in a multi-institutional cohort of patients.Methods:A multi-center retrospective case series study was conducted on clinical data from 42 patients undergoing LMGU for long-segment ureteral strictures (≥5 cm) across five institutions between February 2017 and June 2024. The cohort comprised 31 males and 11 females, with an age of (43.4±12.0) years (range: 15 to 64 years) and a body mass index of (24.6±2.6) kg/m2 (range: 16.0 to 30.0 kg/m2). Strictures involved the left ureter in 24 cases and right ureter in 18 cases, demonstrating a stricture length of (6.4±1.5) cm (range: 5.0 to 11.5 cm). Surgical interventions included either onlay ureteroplasty or augmented anastomotic ureteroplasty, selected according to intraoperative findings. Intraoperative parameters, postoperative complications, and follow-up outcomes were analyzed.Results:Laparoscopic surgery was performed in 22 cases and robot-assisted surgery in 20 cases. Among the 42 patients, 22 underwent onlay ureteroplasty while 20 received augmented anastomotic ureteroplasty. The graft length was (5.9±1.8) cm (range: 3.0 to 12.0 cm), operative time (191.5±55.6) minutes (range: 105.0 to 350.0 minutes), and intraoperative estimated blood loss (86.7±73.6) ml (range: 10.0 to 400.0 ml). All procedures were successfully completed without conversion to open surgery. The postoperative hospital stay was (7.6±2.0) days (range: 4.0 to 15.0 days), with double-J stent removal at 6 to 8 weeks postoperatively. During a follow-up of (49.1±25.0) months (range: 12.0 to 99.0 months), no stricture recurrence was observed in any patient.Conclusion:LMGU is a safe, feasible, and effective long-term technique for managing long-segment (≥5 cm) ureteral strictures.
