|
Drafts | Advantages | Disadvantages |
|
Buccal mucosa graft | Easy to harvest and handle, tolerance to wet environment, good graft “take” | Adversely affected by smoking and betel quid chewing; donor site morbidity such as persistent difficulty with mouth opening and latent parotid duct injury |
Lingual mucosa graft | Easy to harvest, tolerance to wet environment, obtainable long-segment graft harvesting, good graft “take”, acceptable donor site morbidity | Thin and relatively hard to handle; potential donor site morbidity such as difficulty with fine motor of the tongue and slurred speech |
Ileal mucosa flap | Much less intestine needed than simple replacement, much diminished risk of metabolic derangement and mucous production | More difficult to harvest and handle; infeasible when ileal inflammation or other diseases occur; potential donor site complications including intestinal anastomotic infection or leak, anastomotic hemorrhage or stenosis, and adhesive or paralytic intestinal obstruction |
Appendiceal flap | Much less intestine needed than simple replacement, much diminished risk of metabolic derangement and mucous production, maintaining its own blood supply from the appendicular artery | Infeasible when appendiceal inflammation or calculus occurs; potential donor site complications including intestinal anastomotic leak |
Renal pelvis wall graft | Grafts close to reconstructed field, similar to the tissue characteristics of the ureter | Limited data; limited area of graft harvesting; preferably to reconstruct the obstruction of ureteropelvic junction; large graft harvesting may damage the neuromuscular mechanism of renal pelvis |
Bladder mucosa graft | Obtainable long-segment graft harvesting, tolerance to urine corrosion, and minimized stone formation | Donor site morbidity; complications including stricture, hypertrophy, prolapse of the reconstructed site |
Penile/preputial skin graft | Devoid of hair and fat, easy to harvest and handle | Limited data; high recurrence of contracture and restenosis |
Vein patch graft | Easier to harvest and handle; usually available nearby the spermatic or ovarian vein | Limited data; confined to repairing short strictures; complications including fibrosis and restenosis of the reconstructed ureters |
|