Safety and efficacy of lingual mucosa graft ureteroplasty in managing ureteric strictures: a systematic review

Abstract Objective: To review the available literature on lingual mucosa graft (LMG) ureteroplasty and gain a better understanding of the safety, success rates and complications of LMG ureteroplasty for management of ureteric strictures. Methods: A systematic literature review was performed utilising searches in PubMed, MEDLINE, and EMBASE databases. Our search strategy only included articles written in English. All results were screened in detail, and a comprehensive full-text review was carried out on all relevant articles. Methodological quality was assessed using JBI Critical Appraisal tools. Results: A total of 502 articles were identified and assessed for eligibility. All articles were screened thoroughly with 494 exclusions. 8 articles were included in our study, containing a total of 117 cases of LMG ureteroplasties. 68 cases were carried out laparoscopically, and 49 cases were carried out using the robot-assisted approach. The overall successful outcome reported was 113 out of 117 (96.6%) cases, where 67 out of 68 (98.5%) and 46 out of 49 (93.9%) were performed via laparoscopic and robotic-assisted approaches, respectively. The complication rate was 23 out of 117 (19.7%) cases, with a less than 1% (1/117) rate of severe complications (Clavien-Dindo ≥ III). Conclusion: Lingual mucosa graft ureteroplasty demonstrated a high success rate for the management of ureteric strictures, with a high safety profile in both robotic and laparoscopic approaches. Future prospective studies with a larger patient cohort, encompassing varying ureteric stricture lengths and extended follow-up periods are warranted to further validate these findings and potentially further expand the applicability of this procedure.