1.Lingual mucosal graft ureteroplasty for long (≥5 cm) proximal ureteral stricture: a multi-institutional 8-year experience
Xingyuan XIAO ; 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
Chinese Journal of Surgery 2025;63(12):1104-1110
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.
2.The application of the perinephric fat covering technique in lingual mucosal graft ureteroplasty: initial experience of seven patients
Shuaishuai CHAI ; Yuancheng ZHOU ; Manshun DONG ; Qiuxuan YU ; Kangxiang XU ; Gong CHENG ; Chaoqi LIANG ; Xingyuan XIAO ; Bing LI
Chinese Journal of Urology 2025;46(7):544-546
There are no reports on the application of perirenal fat covering technique in lingual mucosal graft ureteroplasty(LMGU),and its safety and effectiveness need to be observed. This study retrospectively analyzed clinical data of 7 patients who underwent lingual mucosa ureteroplasty with intraoperative perirenal fat covering technique. The median stricture length was 5.5(range 4.0 to 6.0)cm,operative duration was 170(range 120 to 230)min,estimated blood loss was 92(range 15 to 110)ml. No conversions to open surgery occurred. During a median follow-up of 46(range 8 to 86)months,all procedures achieved clinical success. The application of perirenal fat covering technique in LMGU is safe and effective.
3.Application of dual fluorescence laparoscopy in the repair of complex ureteral stricture with lingual mucosa graft
Yuancheng ZHOU ; Chaoqi LIANG ; Shuaishuai CHAI ; Ruoyu LI ; Nana LI ; Zhaotai GU ; Xingyuan XIAO ; Bing LI
Journal of Modern Urology 2025;30(3):227-231
Objective: To evaluate the feasibility and effectiveness of dual fluorescence laparoscopy in the localization of ureteral stricture and its blood supply,and to provide a new idea for the treatment of complex ureteral stenosis,thus helping doctors to improve the efficiency of ureteral reconstruction surgery. Methods: Our team developed a dual fluorescence laparoscopic system,which could simultaneously identify the ureter stricture by intra-ureteral injection of methylene blue (MB) and assess the blood supply of the ureteral stumps by intravenous injection of indocyanine green (ICG). Results: The clinical data of 3 patients who underwent lingual mucosa ureteroplasty using dual fluorescence laparoscopy in Zhongnan Hospital of Wuhan University were retrospectively analyzed.All operations were successful,without conversion to open surgery.The operation time was 144,132 and 163 minutes,respectively.The length of harvested lingual mucosa graft was 2.0,2.8 and 3.5 cm,respectively.No intraoperative or postoperative complications occurred.Eight weeks after operation,ureterography showed that the ureter was unobstructed. Conclusion: Dual fluorescence laparoscopy is safe and feasible in the repair of complex ureteral stricture with lingual mucosa graft,which provides a new idea for complex ureteral reconstruction.
4.The application of the perinephric fat covering technique in lingual mucosal graft ureteroplasty: initial experience of seven patients
Shuaishuai CHAI ; Yuancheng ZHOU ; Manshun DONG ; Qiuxuan YU ; Kangxiang XU ; Gong CHENG ; Chaoqi LIANG ; Xingyuan XIAO ; Bing LI
Chinese Journal of Urology 2025;46(7):544-546
There are no reports on the application of perirenal fat covering technique in lingual mucosal graft ureteroplasty(LMGU),and its safety and effectiveness need to be observed. This study retrospectively analyzed clinical data of 7 patients who underwent lingual mucosa ureteroplasty with intraoperative perirenal fat covering technique. The median stricture length was 5.5(range 4.0 to 6.0)cm,operative duration was 170(range 120 to 230)min,estimated blood loss was 92(range 15 to 110)ml. No conversions to open surgery occurred. During a median follow-up of 46(range 8 to 86)months,all procedures achieved clinical success. The application of perirenal fat covering technique in LMGU is safe and effective.
5.Lingual mucosal graft ureteroplasty for long (≥5 cm) proximal ureteral stricture: a multi-institutional 8-year experience
Xingyuan XIAO ; 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
Chinese Journal of Surgery 2025;63(12):1104-1110
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.

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