Appendix interposition for total left ureteral reconstruction

• Published in: Journal of pediatric urology Vol. 5; no. 3; pp. 237 - 239
• Main Authors: Deyl, Rafael Trindade, Averbeck, Márcio Augusto, Almeida, Gilberto Laurino, Pioner, Giovani Thomaz, Souto, Carlos Ary Vargas
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-06-2009
• Subjects: Appendix; Appendix - transplantation; Humans; Infant; Kidney Pelvis - surgery; Male; Necrosis; Pediatrics; Postoperative Complications - pathology; Postoperative Complications - surgery; Reconstructive Surgical Procedures - methods; Surgical Wound Dehiscence - pathology; Surgical Wound Dehiscence - surgery; Transplantation, Autologous; Ureter - pathology; Ureter - surgery; Ureteral diseases; Ureteral obstruction; Ureteral Obstruction - pathology; Ureteral Obstruction - surgery; Urinary Bladder - surgery; Urologic Surgical Procedures, Male - methods; Urology; Ureteral obstruction; Appendix; Ureteral diseases
• ISSN: 1477-5131; 1873-4898
• DOI: 10.1016/j.jpurol.2008.11.010

Abstract Introduction Appendix interposition has been described as an option for surgical reconstruction of partial and total ureteral defects both in children and adults. However, to our knowledge, appendix interposition for a total left ureteral reconstruction has never been described. Case report We report the first case of total left ureteral reconstruction with cecal appendix to connect the renal pelvis of a native kidney to the urinary bladder in a 3-month-old child with ureteral necrosis following pyeloplasty. Results Postoperative recovery was uneventful. Postoperative intravenous pyelogram showed good flow of dye from the pelvis past the appendicular graft into the bladder. After 6 months, the child was asymptomatic, within the normal growth curve for height and weight. Conclusion Total ureteral reconstruction with cecal appendix is a feasible technique in young children. Surveillance for late operative complications is required, since this is the first case of total left ureteral reconstruction with appendix to connect the renal pelvis of a native kidney to the urinary bladder.