Ureteral reconstruction with appendiceal interposition graft following resection of retroperitoneal leiomyosarcoma

Ureteral defects can be repaired using a variety of different techniques that depend on the length and position of the defect. Here we describe a case where a long, upper-ureteral defect was successfully reconstructed using an appendiceal interposition graft. A 60-year-old female patient underwent resection of a right-sided retroperitoneal leiomyosarcoma that was encasing the entire upper ureter and obstructing the right kidney. The mass was resected en bloc, leaving behind an 11 cm ureteral defect. The defect was successfully reconstructed with an appendiceal interposition graft. Appendiceal interposition grafts are a feasible and effective approach for ureteral reconstruction in adults following oncologic resection. We describe various technical aspects that optimize the success of ureteral reconstruction.