Laparoscopic Urinary Tract Reconstruction – Boari Flap and Ileal Substitution

Introduction: The Boari flap technique is a unique urinary tract reconstruction procedure performed after resection of the urinary tract. However, few previous reports have described the application of this technique to gastrointestinal cancer. Moreover, we have not found any papers describing the long-term prognosis. We report a case of right ureteral tract resection followed by Boari flap reconstruction for rectosigmoid carcinoma, with survival for 108 months without any urological complications. Case presentation: A woman in her 50s was diagnosed with rectosigmoid caner by local physician and referred to our institution. Computed tomography revealed right hydronephrosis due to rectosigmoid cancer invasion at the lower two-thirds of the right ureter. During laparotomy, massive lymphatic infiltration from the primary lesion to right ureter was observed. After primary tumor resection with lower ureter excision, the Boari flap procedure was performed to reconstruct the ureteral deficit. Postoperative course was uneventful, and she was discharged on postoperative day 20. The patient has been followed every 4 months for 9 years with no recurrence or unpleasant symptoms. Discussion: This technique is usually performed to manage specific conditions such as ureteral stenosis caused by ureteral calculi, retroperitoneal fibrosis, and gynecological disorders. This procedure should be reconsidered as a possible option for gastrointestinal malignant cases instead of nephrostomy or cutaneous ureterostomy, given the low rate of complications and high patient satisfaction. Conclusion: The Boari flap technique is particularly useful for bridging between the ureter and bladder in cases of colorectal malignancy with combined resection of the lower urinary tract.

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Faculty Opinions recommendation of Complications after use of gastric segments for lower urinary tract reconstruction.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.717962961.793514379 ◽

2016 ◽

Author(s):

Armando Lorenzo

Keyword(s):

Urinary Tract ◽

Lower Urinary Tract ◽

Urinary Tract Reconstruction ◽

Lower Urinary

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Bladder squamous cell carcinoma in a pregnant woman: case report and review of the literature

BMC Urology ◽

10.1186/s12894-020-00772-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Pablo A. Rojas ◽

Cristián González ◽

Gonzalo P. Mendez ◽

Alejandro Majerson ◽

Ignacio F. San Francisco

Keyword(s):

Squamous Cell Carcinoma ◽

Bladder Cancer ◽

Pregnant Woman ◽

Urinary Tract ◽

Cell Carcinoma ◽

Radical Cystectomy ◽

Squamous Cell ◽

Pet Ct ◽

Cell Bladder Cancer ◽

Urinary Tract Reconstruction

Abstract Background Bladder tumors in pregnancy are extremely rare. No more than 50 cases have been published to date, including all histologic variants, and only three cases of bladder squamous cell carcinoma have been described. Case presentation We present a clinical case of a 31-year-old woman with bladder squamous cell carcinoma in the second trimester of pregnancy. After a C-section at 30 weeks, we performed radical cystectomy with extended bilateral lymphadenectomy, hysterectomy and right oophorectomy. The Studer neobladder technique was performed for urinary tract reconstruction. Definitive pathology showed invasive bladder squamous cell carcinoma, Grade 2, with microscopic infiltration of the perivesical fat, negative margins, and 3/28 lymph nodes with carcinoma (pT3aN2M0). The patient underwent 18 months of surveillance after radical cystectomy, without recurrence by PET-CT. Conclusions Bladder cancer in pregnant women is extremely rare but must be considered in those with recurrent gross hematuria and/or recurrent urinary tract infection. To our knowledge, this case involves the longest recurrence-free survival of a pregnant woman with squamous cell bladder cancer published thus far.

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