Rumiantseva, D. I., Mamizhev, E. M., Bashmakova, I. P., & Nosov, A. K. (2025). Clinical Case: Perioperative Fluorescein ICG-Angiography of the Ureters in a Patient with an Orthotopic Neobladder after Repeated Ureteroileoanastomotic Strictures. Voprosy Onkologii, 71(1), 199–204. https://doi.org/10.37469/0507-3758-2025-71-1-199-204

Abstract

Introduction. Radical cystectomy is one of the most complex operations in surgical oncology and urology. The complication rate of the orthotopic urinary reservoir is 40-50 %, including ureteroileoanastomotic strictures in up to 20 % of cases. Perioperative tissue fluorescence allows reliable assessment of the degree of tissue perfusion. We have developed and patented a method for perioperative visualization of the ureter using ICG angiography.

Case description. A 60-year-old man presented with problems with spontaneous urination 7 years after complex treatment for muscle-invasive bladder cancer, including transurethral resection, neoadjuvant chemotherapy and radical cystectomy with formation of an orthotopic urinary reservoir using the Studer technique. Examination revealed repeated strictures of both ureteroileoanastomoses and the presence of nephrostomy drainages. Surgical intervention was performed in the form of laparoscopic reimplantation of both ureters into the orthotopic reservoir using the technique of perioperative fluorescent ICG diagnosis of the ureters. There were no immediate complications during the surgical and post-operative period. Currently, the patient is under dynamic follow-up for more than three years with no evidence of recurrence of ureteroileoanastomotic strictures.

Conclusion. Perioperative ICG angiography is an effective and affordable method for the diagnosis and prevention of postoperative complications associated with ureteroileoanastomosis.

https://doi.org/10.37469/0507-3758-2025-71-1-199-204

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