A new technique for ureteral reconstruction using lingual mucosa grafts in a beagle model

Abstract Background: The ideal technique for ureteral reconstruction has not been established yet. We report our initial experiment to investigate the feasibility of ureteral reconstruction using lingual mucosa graft (LMG) and to evaluate the histological changes of the engrafted LMG in beagles. Methods: Twelve male beagle dogs were randomly divided into groups A, B and C (n=4). A ventral ureteral defect was created by excising half of the ureteral wall. The length of the defect was 3 cm, 6 cm and 10 cm in groups A, B and C, respectively. The LMGs were harvested and employed to repair the ureteral defects in an onlay fashion. Two dogs per group were sacrificed after 6 months, with an additional 2 dogs per group sacrificed after 12 months. Intravenous urography (IVU) and macroscopic examination were performed to evaluate renal function and ureteral patency. Histological changes in the engrafted LMGs during the tissue incorporation process were assessed by histological analysis. Results: There were no postoperative complications. Only one dog in group C developed a mild stricture near the proximal anastomosis . In the remaining 11 animals, IVU showed normal renal function and a wide ureteral caliber without stricture or fistula. The diameter of the LMG-reconstructed ureter was greater than that of the proximal and distal ureter (each p value < 0.01). The LMGs survived in situ with newly formed capillaries. The epithelium of the lingual mucosa resembled the urothelium in postoperative 12 months. Conclusions: This new technique for ureteral reconstruction using LMGs is feasible. This approach is a promising alternative clinical treatment for curing long ureteral strictures.