RECONSTRUCTION OF URETERAL DEFECTS WITH A TUBULAR SKIN-GRAFT SECONDARILY PREFABRICATED UTILIZING OMENTUM AS A CARRIER - AN EXPERIMENTAL-STUDY

Objectives. This study was conducted to evaluate reconstruction of the ureter in dogs after resection of a 7-cm-long midlength segment with a vascularized tubular skin graft secondarily prefabricated utilizing omentum as a carrier. Methods. Nine female mongrel dogs underwent surg ery in which omental surface capabilities were used to create a vascul arized prefabricated skin graft. After 4 weeks, all 9 dogs underwent t he second surgical procedure, which included the resection of a 7-cm-l ong segment from the ureter and an interureteral anastomosis of the om entocutaneous cylindrical tube. At postoperative week 10, just before the third surgical procedure, intravenous urography was performed to e valuate the continuity of the treated ureter. Nephro-ureterectomy was also performed immediately after intravenous urography to obtain speci mens for histologic analysis of the aforementioned tubular anastomosis . Results. The continuity of the ureteral defect was restored with the help of the omentocutaneous cylindrical tube. There was no narrowing throughout the ureter and along the omentocutaneous cylindrical tube. Only minimal dilation occurred at the neoskin tube and at the ipsilate ral collecting system. Histopathologically, there were capillary protr usions entering the skin graft from the omental vasculature. The colum nar epithelium of the cutaneous cylindrical tube was completely preser ved, and transitional ingrowth was present at the proximal and distal ends of the tube. Conclusions. The surgical procedure resulted in succ essful reconstruction of ureteral continuity by the use of a prefabric ated omentocutaneous cylindrical tube in dogs. (C) 1997, Elsevier Scie nce Inc. All rights reserved.