HARVESTING BUCCAL MUCOSA UNDER LOCAL ANESTHESIA – FEASIBILITY AND ACCEPTANCE FOR SUBSTITUTION URETHROPLASTY
Journal
Macedonian Journal of Anesthesia
Date Issued
2020-10
Author(s)
Shabani B
Gurmeshevski S
Dimitrovski A
Abstract
ABSTRACT
Background: The management of male urethral strictures is complex. In recent years, open
reconstruction using a buccal graft has become the preferred primary treatment modality over
repeated minimally invasive options. Hereby we describe the feasibility and safety of buccal
mucosa harvest under local anesthetic agent infiltration for urethroplasty.
Materials and methods: We retrospectively analyzed all patients who underwent open
urethral reconstruction graft surgery with buccal mucosa harvest under local anesthesia between
October 2013 and September 2020. Demographic data of the patients, length of the graft needed
for urethroplasty, pain during and after the harvest, donor site complications were considered
and analyzed.
Results: During this period 18 male patients with anterior urethral strictures underwent open
urethral reconstruction using a buccal mucosa graft harvested under local anesthesia. All procedures
were done by a single surgeon, except in three cases were a buccal nerve block was used to
anesthetize the soft tissues and periosteum buccal to the mandibular molars. The mean harvested
graft length was 4.81 cm (+-2.8 cm) and the mucosa was closed after harvesting. There was no
need for general anesthesia. Sixteen patients (88.88%) reported that it was “easy” to maintain
the mouth open during the procedure. In all of them except in one, there was no significant pain
present during or after the harvest. Only one patient reported a donor site hematoma after the
procedure that required gauze packaging.
Conclusion: Buccal mucosa harvest under local anetshesia is feasable, save and acceptable
for the patients who underwent urethroplasty for urethral stricture disease.
Background: The management of male urethral strictures is complex. In recent years, open
reconstruction using a buccal graft has become the preferred primary treatment modality over
repeated minimally invasive options. Hereby we describe the feasibility and safety of buccal
mucosa harvest under local anesthetic agent infiltration for urethroplasty.
Materials and methods: We retrospectively analyzed all patients who underwent open
urethral reconstruction graft surgery with buccal mucosa harvest under local anesthesia between
October 2013 and September 2020. Demographic data of the patients, length of the graft needed
for urethroplasty, pain during and after the harvest, donor site complications were considered
and analyzed.
Results: During this period 18 male patients with anterior urethral strictures underwent open
urethral reconstruction using a buccal mucosa graft harvested under local anesthesia. All procedures
were done by a single surgeon, except in three cases were a buccal nerve block was used to
anesthetize the soft tissues and periosteum buccal to the mandibular molars. The mean harvested
graft length was 4.81 cm (+-2.8 cm) and the mucosa was closed after harvesting. There was no
need for general anesthesia. Sixteen patients (88.88%) reported that it was “easy” to maintain
the mouth open during the procedure. In all of them except in one, there was no significant pain
present during or after the harvest. Only one patient reported a donor site hematoma after the
procedure that required gauze packaging.
Conclusion: Buccal mucosa harvest under local anetshesia is feasable, save and acceptable
for the patients who underwent urethroplasty for urethral stricture disease.
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