présence d’insuffisance rénale [7]. La résection du
bord anti-mésentérique a été proposée pour diminuer la
surface iléale de réabsorption [24, 26].
CONCLUSION
Dans cette série récente avec un recul moyen de 4,5
ans, l’urétéro-iléoplastie de substitution a permis de
traiter des lésions urétérales, partielles ou totales, com-
plexes avec une faible morbidité. En dehors des contre-
indications essentiellement digestives et en l’absence
d’insuffisance rénale, cette technique doit être une
solution thérapeutique à envisager après échec des
manœuvres endoscopiques et lorsque l’utilisation des
voies urinaires n’est pas possible.
REFERENCES
1. AMIN H. Experience with the ileal ureter. B.J.U., 1976, 48: 19-26.
2. ASSIMOS D.G., PATTERSON L.C., TAYLOR C.L. Changing inci-
dence and etiology of iatrogenic ureteral injuries. J. Urol., 1994,
152, 2240-2246.
3. B A LTACCI S. OG, OZER E., SOYGUR T., BESALTI O.,
ANAFARTA K. Failure of ureteral replacement with gore-tex tube
grafts. Urology, 1998, 51: 400-403.
4. BOXER R.J., SKINNER D.G., KAUFMAN J.J., BELT E., SMITH
R.B., GOODWIN W.E. Replacement of the ureter by small intesti-
ne : clinical application and results of the ileal ureter in 89 patients.
J. Urol., 1979, 121: 728-731.
5. BRITTON K. The radionuclide measurement of disordered renal
function. In: G.D Chisholm DIW, ed. Scientific Foundations of
Urology. London: William Heinemann Medical Books Ltd, 1982.
6. CASSALE A.J., BAUER S.B., RETIK A.B. The use of bowel inter-
posed betwen proximal and distal ureter in urinary tract reconstruc-
tion. J. Urol., 1985, 134: 737-740.
7. CHAHAL R. Letters to the editor. J. Urol., 2000, 163: 1524.
8. CORNET L., MOBIOT L.M., DICK R. Le traitement des sténoses
urétérales bilharziennes par urétéro-iléoplastie. Chirurgie, 198, 109,
297-305.
9. CUKIER J., GRASSET D. Chirurgie de l'uretère. In: Atlas de chi-
rurgie urologique. Paris: Masson, 1985, vol 1.
10. EL FASSI J., LECHEVALLIER E., ORTEGA J.C., EGHAZARIAN
C., RAMPAL M., COULANGE C. Remplacement urétéralpar ileo-
plastie isopéristaltique non modelée. Prog. Urol., 2000, 10:411-417.
11. FRITZSCHE P., DUNCAN CRAVEN J., CAHILL P., GOODWIN
W.E. Long-term radiographic changes of the kidney following the
ileal ureter operation. J. Urol., 1975, 114: 843-847.
12. GIANLUCA E.F.J., EL-MEKRESH M., HOFFENFELLNER R.,
THUROFF J. Ureteral replacement with anti-refluxive colon
segment. XVth Congress of the European Association of
U r o l o g y. Bruxelles: Karger medical and scientific publishers,
2 0 0 0 .
13. GOMEZ-ARAHAM I. Ileal patch ureteroplasty for repair of urete-
ral strictures: Clinical application and result in 4 patients. J. Urol.,
1994, 152: 2000-2004.
14. GOODWIN W.E. The ileal ureter. In: Modern technics in surgery. <;
15. GOODWIN W.E. Surgical tratment of multiple, recurrent branched
(staghorn) calculi by pyelo-nephro-ileo-vesical anastomosis. J.
Urol., 1961, 85, 214-222.
16. JAYANTHI V.R. Reconstructive surgery of the upper urinary tract.
Current Opinion in Urology, 1998, 8:215-220.
17. KÜSS R. Résection segmentaire de l'uretère avec rétablissement de
la continuité. In: Encyclopedie Médico-Chirurgicale ed., Paris,
1970, 41125.
18. MASSON J.C. Remplacement de l'uretére pelvien par l'appendice.
J. Urol. Néphrol., 1973, 79: 900-904.
19. MORALES P.A., HOTCHKISS R.S. Ileal replacement of the ureter.
J. Urol., 1959, 82: 304-310.
20. PARRA R.O. HPG, BOULLIER G.A., CUMMINGS J.M., MEHAN
D.J.. Complications of laparoscopic urological surgery: experience
at St Louis University. J. Urol., 1994, 151: 681-683.
21. POMPEIUS R. Vein patch for repair of short ureteric strictures.
Scandinavian Journal of Urology and Nephrology, 1977, 11: 245-247.
22. POPE J. Ureteral replacement with reconfigured colon subtitute. J.
Urol., 1996, 155: 1693-1695.
23. RACK F.J. Ureteroileal and pyeloileal neocystostomy in man. Ann.
Surg. 1954, 140: 615-622.
24. RAMPAL M., COULANGE C., BENTOLILA E., MASSON J.,
VAILLANT J.L. Remplacement urétéral par un greffon iléal de dia-
mètre réduit. Rapport préléminaire. Prog. Urol., 1991, 1: 92-101.
25. SHOKEIR A.A., BAKR M.A., EL-DIASTY T.A., GHONEIM M.A.
Salvage of difficult transplant urinary fistulae by ileal substitution of
the ureter. Scandinavian J. Urol. Nephrol., 1993, 27:537-540.
26. SHOKEIR A. Further experience with the modified ileal ureter. J.
Urol., 1995, 154: 45-48.
27. TANAGHO E.A. A case against incorporation of bowel segments
into the closed urinary system. J. Urol., 1975, 113: 796-802.
28. TVETER K., GOODWIN W.E. Ileal Ureter: current status. Eur.
Urol., 1980, 6: 321-217.
29. THUROFF J.W., FROHNEBERG D., HOHENFELLNER R , .
Transplantation of a free peritoneal patch in surgery of the renal pel-
vis and ureter. Eur. Urol., 1981, 7: 304-305.
30. WALDNER M., ROTH S. Ileal ureteral substitution in reconstructi-
ve urological surgery: is an antireflux procedure necessary? J. Urol.,
1999, 62:323-326.
____________________
SUMMARY
Non-modelled replacement uretero-ileoplasty.
Objectives: To evaluate the indications and results of replace -
ment uretero-ileoplasties performed over the last six years.
Material and Methods: Over a period of 6 years, 8 patients
u n d e rwent subtotal or total replacement ure t e ro - i l e o p l a s t y
involving a total of 9 renal units. Preoperative temporary urina -
ry diversion was performed in each patient. The mean preope -
rative serum creatinine was 88 µmol/l (range: 53 to 150).
Uretero-ileoplasty was performed for ureteric stricture in 7
cases (bilateral in one case and in a solitary kidney in one case),
ureteric necrosis following renal transplantation without a
donor ureter in one case and urothelial tumour on a solitary kid -
ney in one case.
640
N. Vasse et coll., Progrès en Urologie (2001), 11, 636-641