Abstract
Introduction and Objective:
Benign and malignant ureteral obstruction is a challenging pathology, which has become more common in the past decades, especially in oncologic high-surgical-risk patients with a long life expectancy. Several types of procedures with different surgical approaches have been described, but the optimal management is still debated. The objective of this study is to describe our surgical technique of the DETOUR extra-anatomical ureteral bypass in the treatment of ureteral stenosis and to assess its safety and short-/long-term outcomes.
Material and Methods:
Data from 27 patients who underwent the DETOUR extra-anatomical ureteral bypass were collected prospectively in our center from March 2016 to January 2021. In all cases the DETOUR® extra-anatomical bypass (Coloplast Ltd.) was inserted using a standardized technique. The procedure was conducted under general anesthesia and fluoroscopically and ultrasound guided. Clinical data were collected in a dedicated database. Intra- and perioperative variables and postoperative complications and outcomes of the DETOUR stents were assessed. A descriptive statistical analysis was performed.
Results:
Mean operative time was 112 minutes. Twenty oncologic and seven nononcologic patients were included in the study. Mean hospitalization period was 20.9 days. Clavien–Dindo ≥ Grade 3 postoperative complications were observed in eight patients. Most common severe complication was explant (eight patients with early or late explant). At a mean follow-up of 18.6 months, 8 early and 6 late complications were observed in 14 cases (Clavien–Dindo 1–5).
Conclusions:
Our technique of DETOUR ureteral bypass was considered rather safe and effective, with good long-term results in most patients treated for any type of complex ureteral obstruction in our center.
No competing financial interests exist.
Runtime of video: 9 mins 13 secs
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