Complete left ureter replacement using appendiceal interposition

Abstract

Introduction: Emergency ureteral replacement for large defect, especially in dilapidated abdominal cancer surgery remains an important surgical challenge. Several methods have been described. Here we aimed to present the complete left ureter replacement using appendix interposition, after a large resection of a rectosigmoid mass invading both ureter and iliac artery. Case Report: A 64-year-old male patient diagnosed of a rectosigmoid hinge lesion invading the ureter and iliac artery. He underwent a large tumor resection. The left ureter was cut during the surgery below the renal pelvis with a loss of substance of more than 12 cm. The procedure involved replacement of the ureter by appendix interposition, with wire drainage by transvesicoparietal catheter and a bladder catheter. Neither ureterohydronephrosis nor urinary fistula was observed at the 2-month follow-up computed tomography. Conclusion: In our experience, appendiceal interposition in extensive left ureteral defect is a feasible and safe surgical option.