Long-segmental ureteral reconstruction using tubularization of ileal seromuscular fold: experimental canine study and preliminary clinical experience

Abstract

Objective This study was performed to investigate the feasibility of tubularization of the ileal seromuscular fold for long-segmental ureteral reconstruction in a canine model and assess the clinical application of this procedure. Methods The experimental study was conducted on six beagles. An ileal segment was chosen and folded along its longitudinal axis and thereafter sutured to tubularize the serous surface. The tubularization of the ileal seromuscular fold was designed to be 10 to 12 cm for ureteral substitution. The neo-ureters were pathologically examined. A patient in our hospital also underwent this reconstructive operation. Several blood parameters were assessed and urography was performed for postoperative evaluation. Results All animals and the patient tolerated the operation and recovered as planned. No severe postoperative complications occurred. Blood examination revealed that renal function was within the normal range. Urography indicated patency of urine excretion without leakage or stenosis. In the patient, antegrade urography showed rhythmic peristalsis of the neo-ureter. The pathologic examination revealed a healthy condition of the neo-ureter and an open lumen with a serous epithelial lining. Conclusion Ureteral reconstruction by tubularization of the ileal seromuscular fold is anatomically possible and was preliminarily validated in a patient in the clinical setting.