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A nation-wide multi-institutional evaluation of oral versus colonic mucosal grafts for the treatment of complex long-segment urethral strictures: comparative long-term outcomes and analysis of complications from China.
Сравнительное исследованиеСтатьяМногоцентровое исследованиеНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Liu Ying, Xue Jing-Dong, Li Chao, Zhang Lin-Lin, Zhang Zhuo, Zhang Qing-Bing, Huangpu Xue-Jun, Hou Zi-Zhen, Jiang Hai, Lv Xiang-Guo, Xu Qing-Kang, Liu Zhong-Hua, Sa Ying-Long, Xu Yue-Min, Feng Chao
Аннотация
PURPOSE: To evaluate the efficacy of long-term outcomes and compare the differences between oral mucosal grafts (OMGs) and colonic mucosal grafts (CMGs) in the treatment of complex long-segment urethral stenosis.
METHODS: We conducted a retrospective analysis of patients with long-segment urethral strictures (> 10 cm) who underwent one-stage urethroplasty using either CMGs or OMGs at multiple institutions between 2000 and 2020 in China. Urethral reconstruction with CMGs was performed in 69 patients, while OMG-based urethroplasty was conducted in 225 patients. The primary measure of success was defined as normal voiding and urethrogram results without the need for any postoperative interventions, such as dilations.
RESULTS: In the CMG group, urethroplasty procedures ranged from 11 to 21 cm in length (mean: 17.3 cm), achieving an overall success rate of 85.5% (59/69) with a mean follow-up duration of 145 months (range: 20-258 months). For the OMG group, urethroplasty lengths ranged from 11 to 20 cm (mean: 13.6 cm), with an overall success rate of 81.8% (184/225) and a mean follow-up duration of 58 months (range: 13-150 months). A key limitation of the study was the absence of tools to assess patients' quality of life.
CONCLUSION: Our findings suggest that both CMGs and OMGs are excellent materials for substitution urethroplasty, with both techniques proving effective for managing severe panurethral strictures. The most common complication was meatal stenosis, particularly in patients with lichen sclerosis (LS).
METHODS: We conducted a retrospective analysis of patients with long-segment urethral strictures (> 10 cm) who underwent one-stage urethroplasty using either CMGs or OMGs at multiple institutions between 2000 and 2020 in China. Urethral reconstruction with CMGs was performed in 69 patients, while OMG-based urethroplasty was conducted in 225 patients. The primary measure of success was defined as normal voiding and urethrogram results without the need for any postoperative interventions, such as dilations.
RESULTS: In the CMG group, urethroplasty procedures ranged from 11 to 21 cm in length (mean: 17.3 cm), achieving an overall success rate of 85.5% (59/69) with a mean follow-up duration of 145 months (range: 20-258 months). For the OMG group, urethroplasty lengths ranged from 11 to 20 cm (mean: 13.6 cm), with an overall success rate of 81.8% (184/225) and a mean follow-up duration of 58 months (range: 13-150 months). A key limitation of the study was the absence of tools to assess patients' quality of life.
CONCLUSION: Our findings suggest that both CMGs and OMGs are excellent materials for substitution urethroplasty, with both techniques proving effective for managing severe panurethral strictures. The most common complication was meatal stenosis, particularly in patients with lichen sclerosis (LS).