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Revista chilena de cirugía
versión On-line ISSN 0718-4026
CASTILLO C, OCTAVIO et al. Distal ureteral reconstruction using laparoscopic Boari Flap: experience in 13 cases. Rev Chil Cir [online]. 2008, vol.60, n.3, pp.226-230. ISSN 0718-4026. http://dx.doi.org/10.4067/S0718-40262008000300010.
Background: Tubularized bladder wall flap (Boari flap) is an excellent surgical replacement technique for diseases involving the distal uréter. It allows a simple reconstruction and voids tensión in suture lines. Since 2000 we are performing this operation by laparoscopy. Aim: To report the experience with laparoscopic Boari Flap. Material and methods: Retrospective review of patients subjected to a laparoscopic Boari flap. Patients with a distal uréter stricture, with a urinary bladder of adequate capacity and with a normal ipsilateral renal function, were considered eligible for the operation. Patients with ureteral lesions occurring during gynecologic laparoscopy were also included. The technique consists in the excisión of the diseased uréter and construction of a bladder wall flap that is tubularized and anastomosed to the distal part of the remaining uréter. Results: Thirteen patients aged 9 to 71 years, (seven females) were operated in a lapse of six years. Nine had a benign ureteral stricture. Among these, two had a previous neo-implant with subsequent stenosis, two had ureteral stones, two had a radiation injury secondary to radiotherapy for cervical cáncer, two had ureteral tumors (a transitional cell tumor and an inverted papilloma), two patients had iatrogenic ureteral lesions during gynecological surgery (an inadvertent ureteral ligation and an ureteral sectioning that was repaired and two patients had ureteral stenosis secondary to endometriosis. All patients were followed with intravenous pyelograms. After a mean follow up of 25 months, no patient has lost a kidney or required a new operation. Conclusions: Boari flap is an excellent laparoscopic alternative to replace the distal uréter
Palabras clave : Boari flap; ureteral structure; ureteral reconstruction.