Kurzrock Eric A, Butani Lavjay, Kakker Sudesh P, Perez Richard V
Department of Urology, University of California, Davis Children's Hospital, Sacramento, California 95817, USA.
Pediatr Transplant. 2002 Jun;6(3):240-3. doi: 10.1034/j.1399-3046.2002.01078.x.
Children who develop end-stage renal disease (ESRD) as a result of obstructive uropathies require evaluation and treatment of associated bladder dysfunction to ensure a good outcome following renal transplantation. Bladder dynamics can often be optimized medically, although surgical intervention is occasionally necessary. For those patients who require bladder augmentation, the use of a dilated native ureter (ureterocystoplasty) is preferred to the more commonly used intestine or stomach (enterocystoplasty), which carry a higher risk of complications. Unfortunately, most patients do not have a suitable anatomy for ureterocystoplasty and, by necessity, intestine or stomach has to be utilized. Herein, we describe the successful application of ureterocystoplasty in the presence of ESRD and a solitary kidney prior to renal transplantation. We believe that owing to the many advantages of native urothelium, every effort should be made to use ureter and avoid the use of intestine.
因梗阻性尿路病而发展为终末期肾病(ESRD)的儿童需要对相关膀胱功能障碍进行评估和治疗,以确保肾移植后有良好的预后。膀胱动力学通常可通过药物治疗得到优化,不过偶尔也需要手术干预。对于那些需要膀胱扩大术的患者,使用扩张的自体输尿管(输尿管膀胱扩大术)比更常用的肠或胃(肠膀胱扩大术)更可取,因为后者并发症风险更高。不幸的是,大多数患者没有适合进行输尿管膀胱扩大术的解剖结构,因此必须使用肠或胃。在此,我们描述了在肾移植前,输尿管膀胱扩大术在ESRD和单肾患者中的成功应用。我们认为,由于自体尿路上皮有诸多优点,应尽一切努力使用输尿管并避免使用肠。