Ureter replacement by inverted ileal seromuscular tube or patch

OBJECTIVE: To investigate the outcome of ureter replacement with inverted seromuscular tube in dogs. METHODS: 40 adult mongrel dogs were divided in 5 groups of 8 animals. Each group was divided in 2 subgroups: 1 - sacrifice on 12-15 postoperative days, and 2 - sacrifice on the 60th postoperative day). In group A ureter longitudinal incision 2cm long was sewed with an inverted ileal seromuscular patch 2cm long. In group B ureter incision and patch size were 4cm long. In the remaining groups a ureter segment was replaced by an inverted ileal seromuscular tube 2cm long (group C) or 6cm long (groups D and E). In all groups, except E, ileal mucosa was removed by a grasping maneuver with a scalpel. In group E the ileal mucosa was trimmed away by blunt dissection with a scissors. The ureter permeability was tested by an intravenous urogram, and after sacrifice by anatomic exploration with a catheter. All ureter segment removed through the necropsy were analyzed by histology after hematoxilin-eosin coloration. RESULTS: The number of animals with normal urogram after the followup was: A - 2, B - 2, C - 3, D - 2 and E - 2. Histology revealed that ileal serosa was covered by ureteral mucosa grown from the ureter buds. CONCLUSION: The inverted ileal seromuscular tube or patch does not work well for ureter replacement.

Ureter replacement; ileal seromuscular tube; ureter injury

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