Ureteroplasty using oral mucosa graft: a literature review. Update in 2022

Abstract

Introduction. The review is aimed at analyzing the worldwide experience in the use of the oral mucosa in ureteroplasty due to benign ureteral strictures.Objective. To study the features of the use of the oral mucosa in ureteral reconstruction based on a review of the worldwide literature.Materials and methods. The review was conducted using the PubMed, EMBASE, and the Russian Science Citation Index database. In the first stage, 1013 sources were found, of which 38 articles were selected for inclusion in the review. Of these, 13 studies used an open approach, 15 — robotic, 6 — laparoscopic, 3 — laparoscopic and robotic, 1 — open and laparoscopic. A buccal graft was used in 29 studies and a lingual graft was used in 9 studies.Results. In total, oral mucosal ureteroplasty was performed 308 times in 306 patients: open technique — 64 times, robotic — 145 times, laparoscopic — 99 times. A buccal graft was used in 67.9% (209/308) of the cases, a lingual graft was used in 32.1% (99/308). Postoperative complications were observed in 15.9% (49/308) of the cases: 12.2% after the open technique, 10.4% after the robotic technique and 20.2% after the laparoscopic technique. With a postoperative follow-up period of 1 to 85 months (average 15.3 months), treatment success was achieved in 92.5% (285/308) of the cases: 93.8% for open technique, 88.2% for robotic, 98.0% for laparoscopic.Conclusion. The use of the oral mucosa for ureteroplasty due to benign ureteral stricture allows high rates of efficiency and safety. The results of ureteroplasty do not depend on the choice of surgical approach, type of graft and graft transplantation technique.

Keywords

• ureteral stricture
• ureteroplasty
• buccal graft
• lingual graft
• oral mucosal graft