Trifecta outcome of ureteral reconstruction in iatrogenic injury and non-iatrogenic ureteral lesions: a 10-year experience at a tertiary referral center

Chi Shin Tseng, Ting En Tai, Chung Hung Hong, Chung Hsin Chen, I. Ni Chiang, Yu Chuan Lu, Shih Chun Hung, Kuo How Huang, Chao Yuan Huang, Hong Chiang Chang, Yeong Shiau Pu, Po Ming Chow

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)

Abstract

Purpose: To analyze the trifecta outcome (functional, anatomical, and surgical aspects) of surgical reconstruction for ureteral lesions and investigate the factors affecting the success rate of such reconstruction. Methods: We retrospectively reviewed the data of patients who underwent ureteral reconstruction at our institute between March 2007 and November 2016. Patient profiles, surgical methods, complications, ureteral stenting, laboratory data, and image studies were collected. The trifecta outcome was defined as preserved renal function, no progression of hydronephrosis, and no long-term stenting. The primary endpoint was the percentage of patients who achieved the trifecta outcome. The secondary endpoint was risk factors for trifecta outcome failure. Results: We retrospectively reviewed 178 adult patients who had undergone ureteral reconstruction. The median follow-up period was 37.4 months. In total, 70 (39.3%) patients had iatrogenic ureteral injuries and 108 (60.7%) patients had non-iatrogenic ureteral lesions. Overall, 70% of the patients achieved the trifecta outcome after ureteral reconstruction. A multivariate analysis revealed that risk factors for trifecta failure were malignant diseases [odds ratio (OR) 2.93, p = 0.005], a history of pelvic radiation (OR 3.08, p = 0.032), preoperative estimated glomerular filtration rate < 60 (OR 2.52, p = 0.039), and a type of reconstruction ureteroureterostomy (OR 2.99, p = 0.014). Conclusions: Trifecta outcome could be used to evaluate the ureteral reconstruction in iatrogenic injury and non-iatrogenic ureteral lesions. This study revealed several risk factors that affected the trifecta outcome.

Original languageEnglish
Pages (from-to)1949-1957
Number of pages9
JournalWorld Journal of Urology
Volume37
Issue number9
DOIs
Publication statusPublished - Sep 1 2019

Keywords

  • Iatrogenic injury
  • Reconstruction
  • Ureter
  • Ureteroneocystostomy
  • Ureteroureterostomy

ASJC Scopus subject areas

  • Urology

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