Ureteroplasty for the repair of ureteral stricture using lingual mucosa and buccal mucosa grafts：a meta-analysis.

IF 1.5 4区医学 Q3 UROLOGY & NEPHROLOGY

Urologia Internationalis Pub Date : 2025-03-10 DOI:10.1159/000545041

Xin Zeng, Lingyu Xie, Zhicheng Zeng, Yuanhu Yuan, Hui Xu

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引用次数: 0

Abstract

The study aims to analyze the outcomes of buccal mucosa and lingual mucosa graft reconstruction for repairing ureteral strictures, assessing the efficacy and safety of both surgical approaches.

Methods: A computer search was conducted on PubMed, Embase, and Web of Science using keywords such as "buccal mucosa", "lingual mucosa", "oral mucosa", "ureteral stenosis", and "ureteral reconstruction" to gather relevant literature on lingual mucosa and the efficacy of buccal mucosal reconstruction for ureteral repair. The search spanned from January 2000 to March 2024, focusing on experiments that assessed LMGU (lingual mucosa graft ureteroplasty) or BMGU (buccal mucosa graft ureteroplasty). Variables examined included reconstruction success rate, intraoperative blood loss, stricture length, and perioperative complications. Sensitivity analysis was employed to assess result stability, while funnel plots were utilized to evaluate publication bias in the literature.

Result: A total of 16 single-arm studies were included in the analysis. The combined reconstruction success rates for the LMGU group and BMGU group were 99% (95% CI 95%-100%) and 95% (95% CI 91%-98%) respectively. The mean operation time for the LMGU group was 208.62 minutes (95% CI 181.56-235.68) and for the BMGU group was 190.65 minutes (95% CI 164.38-216.93). Intraoperative blood loss volumes for the LMGU group and BMGU group were 62.33ml (95% CI 43.15-81.51) and 113.44ml (95% CI 77.64-146.23) respectively. Stenosis lengths in the LMGU group and BMGU group were 3.98cm (95% CI 3.27-4.69) and 4.12cm (95% CI 3.24-5) respectively, with a maximum stenosis length repaired of 8cm in both groups. The incidence of postoperative complications was 25% (95% CI 15%-36%) in the BMGU group and 18% (95% CI 11%-26%) in the LMGU group.

Conclusion: LMGU (lingual mucosa graft ureteroplasty) and BMGU (buccal mucosa graft ureteroplasty) are both effective and safe surgical methods for the treatment of long-segment ureteral stenosis. They have shown high effectiveness in treating mid- and upper-segment ureteral stenosis≤8cm.

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输尿管成形术修复输尿管狭窄使用舌粘膜和颊粘膜移植物：荟萃分析。

本研究旨在分析颊粘膜和舌粘膜移植重建修复输尿管狭窄的效果，评估两种手术方式的有效性和安全性。方法：计算机检索PubMed、Embase、Web of Science，关键词为“颊黏膜”、“舌黏膜”、“口腔黏膜”、“输尿管狭窄”、“输尿管重建术”，收集舌黏膜及颊黏膜重建术对输尿管修复效果的相关文献。检索时间从2000年1月到2024年3月，重点是评估LMGU（舌粘膜移植输尿管成形术）或BMGU（颊粘膜移植输尿管成形术）的实验。检查的变量包括重建成功率、术中出血量、狭窄长度和围手术期并发症。采用敏感性分析评价结果的稳定性，采用漏斗图评价文献发表偏倚。结果：共有16项单臂研究纳入分析。LMGU组和BMGU组重建成功率分别为99% （95% CI 95% ~ 100%）和95% （95% CI 91% ~ 98%）。LMGU组的平均手术时间为208.62分钟（95% CI 181.56 ~ 235.68）， BMGU组的平均手术时间为190.65分钟（95% CI 164.38 ~ 216.93）。LMGU组术中出血量62.33ml (95% CI 43.15 ~ 81.51)， BMGU组术中出血量113.44ml （95% CI 77.64 ~ 146.23）。LMGU组和BMGU组狭窄长度分别为3.98cm （95% CI 3.27-4.69）和4.12cm (95% CI 3.24-5)，两组最大修复狭窄长度均为8cm。BMGU组术后并发症发生率为25% (95% CI 15% ~ 36%)， LMGU组术后并发症发生率为18% （95% CI 11% ~ 26%）。结论：舌部粘膜输尿管成形术和颊部粘膜输尿管成形术是治疗长段输尿管狭窄的有效、安全的手术方法。对输尿管中上段狭窄≤8cm的患者疗效显著。

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

Urologia Internationalis 医学-泌尿学与肾脏学

CiteScore

3.30

自引率

6.20%

发文量

审稿时长

3-8 weeks

期刊介绍： Concise but fully substantiated international reports of clinically oriented research into science and current management of urogenital disorders form the nucleus of original as well as basic research papers. These are supplemented by up-to-date reviews by international experts on the state-of-the-art of key topics of clinical urological practice. Essential topics receiving regular coverage include the introduction of new techniques and instrumentation as well as the evaluation of new functional tests and diagnostic methods. Special attention is given to advances in surgical techniques and clinical oncology. The regular publication of selected case reports represents the great variation in urological disease and illustrates treatment solutions in singular cases.