Ileal Ureter Substitution Used Yang-Monti Principle in Ureteral Injury Repair--- 2 Cases Report

使用片段迴腸皮瓣以Yang-Monti原則改造填補輸尿管缺陷病例報告

Hong-Lin Cheng M.D.

Department of Urology, Medical College and Hospital, National Cheng Kung University, Tainan, Taiwan

鄭鴻琳

國立成功大學 醫學院及附設醫院 泌尿部

Purpose:

To present the results of 2 patients undergoing ileal ureter substitution with Yang-Monti principle in long ureteral repair.

Case 1:

 A 37-year-old male, presented with left ureteral stone, experienced total ureter avulsion injury during ureteroscopic manipulation. At the same time, 3 segments of 2.5-cm ileum were separated and with Yang-Monti principle were rebuilt to connect into a 15-cm long tube as well as replacing the whole avulsion ureter.

Case 2:

A 61-year-old female presented with left ureteral obstruction 10 months after laparoscopic partial nephrectomy performed for renal cancer. A 2-cm segment of terminal ileum was rebuilt to anastomose a 5-cm ureteral defect.

Results:

In case 1, after 17- year follow-up, imaging studies showed moderate hydronephrosis and renal function was preserved with estimated GFR 66 ml/min. In case 2, after 1- year follow-up, ultrasound revealed mild hydronephrosis with renal cortex preserved.

Conclusions:

A short segment of ileum applying Yang-Monti principle to substitute for ureteral defect or several segments for whole ureter is feasible and effective to preserve renal function.