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A new treatment for retroperitoneal fibrosis: initial experiences of using S eprafilm ® to wrap the ureter
Author(s) -
Kamihira Osamu,
Hirabayashi Tsuyoki,
Yamaguchi Asaomi,
Hirabayashi Hiroki,
Moriya Yoshie,
Fukatsu Akitoshi,
Yoshikawa Yoko,
Matsuura Osamu,
Kimura Kyosuke
Publication year - 2014
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/bju.12701
Subject(s) - medicine , ureter , retroperitoneal fibrosis , stenosis , surgery , pyelogram , retroperitoneal space , scintigraphy , fibrosis , urology , radiology
Objective To confirm the efficacy of using S eprafilm ® ( G enzyme C orp., C ambridge, MA , USA ) for wrapping the ureter to treat the ureteric stenosis caused by retroperitoneal fibrosis ( RPF ). Patients and Methods Between A ugust 2010 and S eptember 2012, 11 ureters in eight patients with RPF (seven males and one female, mean age 65 years) were treated. The mean (range) length of the narrow segment of the ureter was 30 (10–90) mm. During surgery, after having been released from adhesive tissue, the stenotic segment of the ureter was wrapped with Seprafilm to isolate it from the surrounding tissue. A radiographic follow‐up was performed every 6 months using computed tomography, i.v. pyelography and/or 99m T c‐mercapto‐acetylglycyl‐glycyl‐glycine ( 99m T c‐ MAG3 ) renal scintigraphy. Results For the unilateral operations, the mean estimated blood loss was 39 mL, and the mean operating time was 154 min. All ureters were isolated from the fibrotic tissue and wrapped with Seprafilm successfully without major complications. During the mean follow‐up period of 17 months, no ureteric restenoses were observed in the affected sides, but new stenosis occurred in the contralateral side of the ureter in one patient. Conclusions Although the follow‐up period is still limited, we believe that the use of S eprafilm has the potential to become an effective option in the treatment of ureteric stenosis caused by RPF , when the omentum cannot be used. To establish the relative advantages of using Seprafilm over performing a standard omental wrap, further experimentation will be required to compare the two techniques.