The study aims to analyze the outcomes of buccal mucosa and lingual mucosa graft reconstruction for repairing ureteral strictures, assessing the efficacy and safety of both surgical approaches.
Methods: A computer search was conducted on PubMed, Embase, and Web of Science using keywords such as “buccal mucosa”, “lingual mucosa”, “oral mucosa”, “ureteral stenosis”, and “ureteral reconstruction” to gather relevant literature on lingual mucosa and the efficacy of buccal mucosal reconstruction for ureteral repair. The search spanned from January 2000 to March 2024, focusing on experiments that assessed LMGU (lingual mucosa graft ureteroplasty) or BMGU (buccal mucosa graft ureteroplasty). Variables examined included reconstruction success rate, intraoperative blood loss, stricture length, and perioperative complications. Sensitivity analysis was employed to assess result stability, while funnel plots were utilized to evaluate publication bias in the literature.
Result: A total of 16 single-arm studies were included in the analysis. The combined reconstruction success rates for the LMGU group and BMGU group were 99% (95% CI 95%-100%) and 95% (95% CI 91%-98%) respectively. The mean operation time for the LMGU group was 208.62 minutes (95% CI 181.56-235.68) and for the BMGU group was 190.65 minutes (95% CI 164.38-216.93). Intraoperative blood loss volumes for the LMGU group and BMGU group were 62.33ml (95% CI 43.15-81.51) and 113.44ml (95% CI 77.64-146.23) respectively. Stenosis lengths in the LMGU group and BMGU group were 3.98cm (95% CI 3.27-4.69) and 4.12cm (95% CI 3.24-5) respectively, with a maximum stenosis length repaired of 8cm in both groups. The incidence of postoperative complications was 25% (95% CI 15%-36%) in the BMGU group and 18% (95% CI 11%-26%) in the LMGU group.
Conclusion: LMGU (lingual mucosa graft ureteroplasty) and BMGU (buccal mucosa graft ureteroplasty) are both effective and safe surgical methods for the treatment of long-segment ureteral stenosis. They have shown high effectiveness in treating mid- and upper-segment ureteral stenosis≤8cm.