Die Kombination von Veneninterponat und resorbierbarem Stent als innovatives Therapieverfahren zur Versorgung von proximalen Ureterdefektläsionen

Background: In case of ureter defect lesions elaborate surgical interventions are necessary like ureter replacement using small bowel or autotransplantation. We developed a new technique for ureter defect reconstruction in a pig model using a vein and resorbable polylactate-acid (PLLA) stent. Methods: External jugular vein was removed in 42 pigs and used as an autologous vein graft. A three cm segment was resected from the proximal ureter and replaced by the vein with or without endoluminal biodegradable PLLA stent. 14 animals served as controls. Survival, kidney function and morphological changes of the neo-ureter and the kidney were observed for 7 days respectively six months. Results: The degradable stent material had been completely broken down after six months and the vein had been relined with urothel showing Ck7-positive columnar epithelium and newly formed capillaries in the neo-ureteral wall. All animals showed normal kidney function in follow up. Conclusions: Using an autologous vein graft and a bio-degradable endoluminal stent is feasible for ureter defect reconstruction. Due to the preservation of physiological urine passage and anti-reflux mechanism it constitutes an interesting alternative method.