Fabrizio Dal Moro1,2, Veronica Macchi3, Andrea Porzionato3, Francesco G Mandato4, Raffaele De Caro3. 1. Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy - fabrizio.dalmoro@unipd.it. 2. Santa Maria della Misericordia University Hospital, University of Udine, Udine, Italy - fabrizio.dalmoro@unipd.it. 3. Department of Neurosciences, Institute of Anatomy, University of Padua, Padua, Italy. 4. Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy.
Abstract
BACKGROUND: Ureteral defect lesions may result from retroperitoneal fibrosis, radiation damage, tumors, or surgical procedures; the management of long-segment ureteral defects is a challenge for urologists. Total or partial replacement of the ureter is sometimes required, with consequent ileal interposition, but this technique may lead to several complications, such as severe urinary infections. In a few cases, nephrectomy may be required. Starting from the above considerations, we can postulate the RUG technique (replacement of the ureter with gonadal vein), using the gonadal vein (GoV) as an autologous graft to substitute the ureter. For this reason, we decided to test this novel idea on an experimental model. METHODS: We tested the above technique on a cadaveric model, performing complete procedure (RUG #1), segmental replacement of the ureter (RUG #2), and ureteroplasty with a GoV patch (RUG #3). All the procedures involved an open approach. After RUG #3, the treated segment of the ureter was sampled for histologic analysis. RESULTS: Four RUGs were performed (two RUG #1, one RUG #2, one RUG #3). All anatomic structures were easily identified, and all procedures were completed successfully. The dimensions of the ureters were comparable to those of the GoV in all cases, as usual. Histologic analysis demonstrated perfect adherence of the two anastomosed structures. CONCLUSIONS: The RUG technique resulted in an adequate, safe and easy-to-perform surgical alternative.
BACKGROUND:Ureteral defect lesions may result from retroperitoneal fibrosis, radiation damage, tumors, or surgical procedures; the management of long-segment ureteral defects is a challenge for urologists. Total or partial replacement of the ureter is sometimes required, with consequent ileal interposition, but this technique may lead to several complications, such as severe urinary infections. In a few cases, nephrectomy may be required. Starting from the above considerations, we can postulate the RUG technique (replacement of the ureter with gonadal vein), using the gonadal vein (GoV) as an autologous graft to substitute the ureter. For this reason, we decided to test this novel idea on an experimental model. METHODS: We tested the above technique on a cadaveric model, performing complete procedure (RUG #1), segmental replacement of the ureter (RUG #2), and ureteroplasty with a GoV patch (RUG #3). All the procedures involved an open approach. After RUG #3, the treated segment of the ureter was sampled for histologic analysis. RESULTS: Four RUGs were performed (two RUG #1, one RUG #2, one RUG #3). All anatomic structures were easily identified, and all procedures were completed successfully. The dimensions of the ureters were comparable to those of the GoV in all cases, as usual. Histologic analysis demonstrated perfect adherence of the two anastomosed structures. CONCLUSIONS: The RUG technique resulted in an adequate, safe and easy-to-perform surgical alternative.
Authors: Elena Stocco; Andrea Porzionato; Enrico De Rose; Silvia Barbon; Raffaele De Caro; Veronica Macchi Journal: J Tissue Eng Date: 2022-01-25 Impact factor: 7.813
Authors: Carmelo Pirri; Carla Stecco; Andrea Porzionato; Rafael Boscolo-Berto; René H Fortelny; Veronica Macchi; Marko Konschake; Stefano Merigliano; Raffaele De Caro Journal: Front Surg Date: 2021-06-23