Histopathological correlations to ureteral lesions visualized during ureteroscopy.

Autor: Lildal SK; Department of Urology, Urological Research Centre, Lillebaelt Hospital, Kabbeltoft 25, 7100, Vejle, Denmark.; Institute of Regional Health Research, University of Southern Denmark, Vejle, Denmark., Sørensen FB; Department of Clinical Pathology, Lillebaelt Hospital, Vejle, Denmark.; Institute of Regional Health Research, University of Southern Denmark, Vejle, Denmark., Andreassen KH; Department of Urology, Urological Research Centre, Lillebaelt Hospital, Kabbeltoft 25, 7100, Vejle, Denmark.; Institute of Regional Health Research, University of Southern Denmark, Vejle, Denmark., Christiansen FE; Department of Urology, Urological Research Centre, Lillebaelt Hospital, Kabbeltoft 25, 7100, Vejle, Denmark., Jung H; Department of Urology, Urological Research Centre, Lillebaelt Hospital, Kabbeltoft 25, 7100, Vejle, Denmark., Pedersen MR; Department of Urology, Urological Research Centre, Lillebaelt Hospital, Kabbeltoft 25, 7100, Vejle, Denmark.; Institute of Regional Health Research, University of Southern Denmark, Vejle, Denmark., Osther PJS; Department of Urology, Urological Research Centre, Lillebaelt Hospital, Kabbeltoft 25, 7100, Vejle, Denmark. palle.joern.osther@rsyd.dk.; Institute of Regional Health Research, University of Southern Denmark, Vejle, Denmark. palle.joern.osther@rsyd.dk.
Jazyk: angličtina
Zdroj: World journal of urology [World J Urol] 2017 Oct; Vol. 35 (10), pp. 1489-1496. Date of Electronic Publication: 2017 Apr 12.
DOI: 10.1007/s00345-017-2035-3
Abstrakt: Purpose: To correlate ureteral lesions visualized during ureteroscopy with histopathological findings.
Materials and Methods: Ureteral access sheaths (UAS) sized 13/15 Fr. were inserted bilaterally in 22 laboratory pigs. During retraction of the UAS with a semirigid ureteroscope inside, ureteral lesions were evaluated and registered using the Post-ureteroscopic lesion scale (PULS). Ureters were excised in vivo between the uretero-pelvic junction and the uretero-vesical junction. Embedded in paraffin, 4-µm thick sections were step sectioned at 250-300 µm intervals and haematoxylin and eosin (HE) stained. Histopathological scoring of ureteral wall lesions was subsequently performed according to PULS.
Results: In 72.1% of ureters, the highest histopathological score was at least 1 grade higher than the highest endoscopic PULS score. For 12 (27.9%) lesions, the difference was 2 scores higher, and for 1 (2.3%), it was 3 scores higher. The histopathological PULS grade was higher than the endoscopical PULS grade at all minimum, quartile, and maximum scores. There was a significant difference in the distribution of highest lesional scores between the endoscopic and histopathological PULS (p = 0.002). The calculated mean of the highest scores was 1.49 for endoscopic PULS and 2.51 for histopathological PULS (p < 0.0001).
Conclusion: Histopathological evaluation of ureteral wall lesions after UAS placement revealed a significantly higher degree of severity than observed endoscopically. Thus, endoscopy underestimated the histopathological extent of the lesion in the majority of cases.
Databáze: MEDLINE
Externí odkaz: