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Query: UMLS:C0403608 (ureter)
 9,655 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A retrospective study comprising 18 patients with transitional cell renal pelvis tumours (TCPT) was carried out to evaluate the results after two different surgical procedures for nephroureterectomy. The kidney was removed by a flank incision and the lower part of the ureter by either an incision in the lower part of the abdomen or intussusception of the ureter followed by transurethral resection of the ureteral orifice. Eight patients were subjected to nephroureterectomy by means of two incisions and another eight patients underwent a simple nephrectomy followed by ureteral intus-susception and transurethral resection. Two patients received other treatments. After nephroureterectomy with a separate incision for ureterectomy, the average hospital stay was 12 days, compared with 7.5 days in patients operated upon with only one abdominal incision. Recurrence of tumour or survival was not significantly different in the two groups.
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PMID:One or two incisions for nephroureterectomy in transitional cell renal pelvis tumours. 940 1

Between August 1986 and December 1998, 19 patients who had renal pelvic and upper ureteral tumors were treated with nephrectomy and transurethral removal of the ureter using the intussusception method. Removal of the ureter failed in 5 patients because of excessive ablasion of the ureter or insufficient electro-resection around the ipsilateral ureteral orifice. Excluding those patients, the safety of the operation and the intravesical recurrence were compared with the outcome in 12 patients undergoing partial cystectomy for similar tumors. The mean operating time was not significantly shorter with the intussusception method compared with partial cystectomy (190.4 versus 251.3 minutes), but the mean blood loss was significantly smaller (187.5 versus 460.2 ml) and the intussusception method did not require a blood transfusion. The mean term of hospitalization was 20.3 days for patients treated by the intussusception method which was significantly shorter than that for patient undergoing partial cystectomy (25.4 days). Intravesical recurrence was found in seven patients (50%) treated by the intussusception method and the 1- and 5-year recurrence-free rates were 69.2% and 30.8% respectively. There was no significant difference in the recurrence-free rates between the two surgical techniques. These results suggest that the intussusception method is superior to partial cystectomy in decreasing the operating time, blood loss and term of hospitalization. It can be an attractive option in selected cases, without increasing the risk of intravesical recurrence.
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PMID:[Transurethral removal of the ureter by the intussusception method in the treatment of renal pelvic and ureteral tumors]. 1084 54

Replacement plasty allows to perform oncology surgery while maintaining body image and preserving renal function. Entero-ureteral anastomosis is a significant element in this procedure where the main responsible for the loss of renal function are stenosis, infection and reflux. Our group has performed 206 orthotopical vesical replacements (November 1981-November 1998), using a direct Wallace-type uretero-ileal anastomosis. An intussusception valve system was used as antireflux mechanism. The number of obstructions, rate of stenosis at the uretero-ileal junction and incidence of valve stenosis were all analyzed as part of the complications occurred over a follow-up period of 54 months (6-183). Findings included 6 stenosis at the uretero-intestinal junction and 2 at the intussusception valve. Two (3.8%) of the uretero-ileal stenosis were earlier and associated to fistula; one was treated with open surgery and one had a double J placed through antegrade percutaneous access. Of the remaining late four, only one was treated with a double J catheter while the other three had to be re-operated. Stenoses of the valvular system (1.2%) were solved with open surgery. From our experience, we believe that direct uretero-ileal implantation with scraping of the ureter is a safe technique with little risk for stenosis at the uretero-ileal junction. Intussusception was used a antireflux system in all cases.
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PMID:[Ureteral stenosis of uretero-ileal anastomosis]. 1096 72

In some cases of primary transitional cell carcinoma (TCC), there may be some uncertainty in clinical decision making. We present a case in which a pT1-N0 urothelial tumor was found in the renal pelvis after an open nephrectomy for urolithiasis. Because incomplete excision of the ureter can lead to recurrence of the TCC, we deemed it necessary to remove the residual ureter. Therefore, a combined endoscopic-transvescical laparoscopic ureterectomy was performed. The transabdominal approach was chosen for the procedure, because the patient had already undergone open nephrectomy with retroperitoneal access and was thus likely to have adhesions and inflammation in the region. For the endoscopic phase of surgery, a technique of ureteral intussusception was combined with transurethral resection. The choice of the endoscopic transurethral procedure was prompted by the fact that transurethral resection of the ureteral orifice and invagination ureterectomy has already been proposed as the first step of nephroureterectomy. The combined endoscopic laparoscopic procedure was not technically demanding; the ureterectomy took no longer than an open procedure. The surgery was uneventful, and the patient resumed normal activities the day after surgery. The broader issue of whether this technique should be adopted by the urological community at large as a routine practice requires longer follow-up outcome data.
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PMID:An atypical presentation of upper urothelial tumor. 1128 44

Recent advances in pediatric surgery have been made in several fields. Hydrocephalus is again being treated by draining the cerebrospinal fluid into either the ureter, the mastoid antrum or the peritoneal cavity. Funnel chest should be corrected surgically. Congenital atresia of the esophagus is best treated by a one-stage operative repair. Patent ductus should be closed. Operations are available for cyanotic children. Intussusception is again being treated by barium enema in selected cases. Megacolon can be benefited by surgical procedures, which now are directed at the distal spastic segment rather than the proximal dilated segment.
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PMID:Advances in pediatric surgery. 1300 76

A 64-year-old woman underwent right nephroureterectomy of the ureter by the intussusception method under the diagnosis of right renal pelvic tumor in December 2001. Stress incontinence appeared postoperatively, and though conservative treatment was performed, it did not improve. The result of the pad-weighting test was 56 g indicating serious incontinence. In chain cystography, contrast media from the posterior wall of the urinary bladder to the vagina leaked out by the lateral view, and in cystoscopy, a fistula of about 2 mm in diameter was recognized in the right ureteral orifice trace. Under the diagnosis of vesicovaginal fistula, we performed transvaginal repair of the vesicovaginal fistula in November 2003. The urethral catheter was removed on the 14th postoperative day. After removal of the urethral catheter, urge incontinence was recognized, but it improved gradually. The recurrence of fistula and tumor has not been recognized at present.
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PMID:[Vesicovaginal fistula which arose postoperatively after removal of the ureter by the intussusception method for renal pelvic tumor: a case report]. 1557 22

Ureteric intussusception is exceptional. The authors report a case of hydronephrosis due to retrograde intussusception of the subpelvic ureter in a 3-month-old boy admitted for respiratory distress syndrome associated with fever of 39 degrees C. Imaging revealed the presence of marked dilatation of the left kidney. Surgical exploration demonstrated hydronephrosis secondary to obstruction due to ureteric intussusception. This is the first case of ureteric intussusception reported in a child.
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PMID:[Hydronephrosis due to retrograde ureteric intussusception]. 1609 62

Surgical treatment of primary obstructive megaureter is generally recommended when ureteral dilatation is likely to contribute to symptoms such as pyelonephritis or calculi. The authors' objective for this study was to present the surgical results performing ureteral reimplantation, combined with modified Lich-Gregoir antireflux procedure (using anchoring stitch) over a 10 year period. The average operative time for ureteral reimplantation was 259.64 minutes. The authors' success rate was 92% and all patients had no postoperative ureteral obstruction from intussusception of reimplanted ureter Follow-up postoperative renal sonography at 22 weeks showed a decrease in hydronephrosis in 92%. The authors concluded that the surgical results were comparable with surgical results of other techniques and an anchoring stitch should be considered to prevent postoperative ureteral obstruction from ureteral intussusception.
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PMID:Results of surgical repair of primary obstructive megaureter. 1669 16

Intussusception of the ureter is a rare complication of some ureteral diseases. A 49-year-old man was found to have a ureteral intussusception in the middle part of the right ureter accompanied by a polyp below the invaginated segment of the ureter. Surgery confirmed the diagnostic imaging findings. Here, we present a case of ureteral intussusception associated with a fibroepithelial polyp and discuss the radiological characteristics.
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PMID:Ureteral intussusception due to a polyp. 1715 95

Approximately 5% of all urothelial tumors in adults arise from the upper tracts. While the gold standard treatment is open nephroureterectomy, laparoscopic nephroureterectomy is becoming increasingly popular. Oncologic principles dictate that complete excision of the transmural ureter and bladder cuff and avoidance of urine spillage are paramount. This can be challenging laparoscopically and multiple techniques have been described. We review described surgical techniques, published oncologic data, as well as advantages and disadvantages for each technique including open excision, cystoscopic detachment and ligation, laparoscopic stapling, ureteral intussusception, transurethral resection of ureteral orifice (TURUO) and modifications of TURUO. To date, no controlled studies have been performed demonstrating one technique's superiority.
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PMID:Management of distal ureter in laparoscopic nephroureterectomy--a comprehensive review of techniques. 1860 40


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