Unraveling the Complexities of Uretero-Enteric Strictures: A Modern Review.

IF 2.5 2区医学 Q2 UROLOGY & NEPHROLOGY

Current Urology Reports Pub Date : 2024-11-01 Epub Date: 2024-08-14 DOI:10.1007/s11934-024-01222-8

A Abdalla, Joshua A Cohn, J Simhan

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Abstract

Purpose of review: The purpose of this review article is to provide a contemporary overview of benign uretero-enteric anastomotic stricture (UAS) management and outcomes.

Recent findings: In this article, we will review the most recent studies investigating UAS and evaluate etiology, potential risk factors, presentation, diagnosis, and management options, along with personal insight gained from our experience with managing this challenging reconstructive complication. Benign UAS is a relatively common long-term complication of intestinal urinary diversion, affecting approximately 1 in 10 patients. It is thought to be caused by ureteral tissue ischemia and fibrosis at the anastomotic site. Risk factors appear to include any that increase the likelihood of leak or ischemia; it is not clear if anastomotic approach impacts risk for stricture as well. Management options are varied and include endourologic, open, and robotic approaches. Endoscopic approaches may be less morbid but are considerably less effective than reconstruction performed after a period of ureteral rest.

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解读输尿管-肠管狭窄的复杂性：现代回顾。

综述的目的：这篇综述文章的目的是对良性输尿管-肠管吻合口狭窄（UAS）的管理和结果进行当代概述：在本文中，我们将回顾有关 UAS 的最新研究，评估病因、潜在风险因素、表现、诊断和处理方案，以及我们在处理这种具有挑战性的重建并发症时获得的个人见解。良性 UAS 是肠道尿路改道术中一种相对常见的长期并发症，大约每 10 名患者中就有 1 人患病。它被认为是由吻合部位的输尿管组织缺血和纤维化引起的。风险因素似乎包括任何增加漏尿或缺血可能性的因素；目前还不清楚吻合方式是否也会影响狭窄风险。处理方法多种多样，包括内窥镜、开放式和机器人方法。内窥镜方法可能发病率较低，但与输尿管休息一段时间后进行的重建相比，效果要差得多。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Urology Reports UROLOGY & NEPHROLOGY-

CiteScore

4.60

自引率

3.80%

发文量

期刊介绍： This journal intends to review the most important, recently published findings in the field of urology. By providing clear, insightful, balanced contributions by international experts, the journal elucidates current and emerging approaches to the care and prevention of urologic diseases and conditions. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as benign prostatic hyperplasia, erectile dysfunction, female urology, and kidney disease. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.