Pappas P, Giannopoulos A, Stravodimos K G, Zavos G, Alexopoulos T, Boletis J, Tzortzis G, Kostakis A
Department of Radiology, Laiko Hospital, Athens, Greece.
J Endourol. 2001 Sep;15(7):719-23. doi: 10.1089/08927790152596316.
Renal transplantation is an effective treatment for end-stage renal disease. Ureteral stenosis is the most frequent urologic complication. We report our experience with percutaneous nephrostomy and antegrade ureteral stenting, which may offer a primary and definitive alternative to open surgery.
Fifteen patients with renal allograft obstructive uropathy were managed with percutaneous nephrostomy and prolonged ureteral stenting.
Percutaneous nephrostomies were successfully performed in all 15 kidneys: In 13 patients, antegrade ureteral stenting was attempted, this being successful in 11 (85%). After prolonged ureteral stenting (mean duration 15 months), the stent was removed in eight patients, and six of them (75%) did not have recurrences. During follow-up, urea, creatinine, sodium, and potassium determinations and ultrasound scans were performed, and success was confirmed by the decline of creatinine and reduction in hydronephrosis. No major complication was observed.
Percutaneous nephrostomy and ureteral stenting is a safe and effective treatment for renal allograft obstructive uropathy. Prolonged ureteral stenting may offer a definitive treatment with low morbidity.
肾移植是终末期肾病的有效治疗方法。输尿管狭窄是最常见的泌尿系统并发症。我们报告了经皮肾造瘘术和顺行输尿管支架置入术的经验，这可能为开放手术提供一种主要且确定的替代方法。
15例肾移植受者发生移植肾梗阻性尿路病，接受了经皮肾造瘘术和长期输尿管支架置入术。
15个肾脏均成功实施了经皮肾造瘘术：13例患者尝试了顺行输尿管支架置入术，其中11例（85%）成功。长期输尿管支架置入（平均持续时间15个月）后，8例患者取出了支架，其中6例（75%）未复发。随访期间，进行了尿素、肌酐、钠和钾测定以及超声检查，肌酐下降和肾积水减轻证实了治疗成功。未观察到重大并发症。
经皮肾造瘘术和输尿管支架置入术是治疗肾移植梗阻性尿路病的安全有效方法。长期输尿管支架置入术可能提供一种发病率低的确定性治疗方法。
