Autor: |
Lin CS; Department of Surgery, Taichung Veterans General Hospital, Taichung 40705, Taiwan., Lee JR; Department of Urology, Taichung Veterans General Hospital, Taichung 40705, Taiwan., Chiu KY; Department of Urology, Taichung Veterans General Hospital, Taichung 40705, Taiwan., Wang SS; Department of Urology, Taichung Veterans General Hospital, Taichung 40705, Taiwan., Chen CS; Department of Urology, Taichung Veterans General Hospital, Taichung 40705, Taiwan., Lin YJ; Department of Family Medicine, Taichung Veterans General Hospital, Taichung 40705, Taiwan., Che CC; Department of Urology, Taichung Veterans General Hospital, Taichung 40705, Taiwan.; Department of Medicine and Nursing, Hungkuang University, Taichung 43304, Taiwan. |
Abstrakt: |
Background and Objectives: Ureteral reconstruction is aimed at maintaining ureteral patency without the need for long-term catheters like ureteral stents or percutaneous nephrostomies. Different surgical strategies are adopted based on the etiology, the location of the injury, and the severity of the injury. We aimed to analyze the parameters that can predict which patients might not be free from further catheterization after reconstruction. Materials and Methods: This study included patients who underwent ureteral reconstruction from January 2007 to December 2021. The success of ureteral reconstruction was defined as being free from further catheterization after the operation. Results: A total of 184 patients underwent ureteral reconstruction. Malignant disease with ureteral invasion and iatrogenic injuries accounted for 79.9% of the cases. The majority (79.3%) did not have to undergo subsequent interventions. Predictors for a failed result of ureteral reconstruction included a history of radiotherapy (OR = 2.75, p = 0.01), chronic kidney disease (CKD) (OR = 3.42, p < 0.001), and an upper ureteric location of the injury (OR = 5.68, p = 0.042). Conclusions: A history of radiation therapy, an upper third ureteric location of the injury, and CKD were identified as predictors of a failed ureteral reconstruction. Malignant diseases, surgical methods, and repair techniques did not significantly affect the outcome of the operation. |