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01-09-2019 | Original Article

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

Authors: 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

Published in: World Journal of Urology | Issue 9/2019

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.

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Title: Trifecta outcome of ureteral reconstruction in iatrogenic injury and non-iatrogenic ureteral lesions: a 10-year experience at a tertiary referral center
Authors: 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
Publication date: 01-09-2019
Publisher: Springer Berlin Heidelberg
Published in: World Journal of Urology / Issue 9/2019
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-018-2600-4

At a glance: The STEP trials

Springer Medicine

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

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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