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[肾移植术后尿路梗阻的处理:16例报告]

[Management of urinary obstruction following renal transplantation: report of 16 cases].

作者信息

Nie Hai-bo, He Hui-xu, Li Xun, Deng Zhi-xiong, Zhu Yun-song, Hu Wei-lie, Lu Jun, Qiu Xiao-fu, Zhang Xiao-ming

机构信息

Department of Urology, Guangzhou General Hospital of Guangzhou Command, Guangzhou 510010, China.

出版信息

Di Yi Jun Yi Da Xue Xue Bao. 2005 Nov;25(11):1454-5.

Abstract

OBJECTIVE

To explore the diagnosis and treatment of urinary obstruction involving the transplanted kidney.

METHODS

A retrospective analysis was performed in 16 cases of urinary obstruction involving the transplanted kidney, including 5 cases of ureteral calculi, 6 vesicoureteral anastomotic stricture, 2 pyeloureteral junction stricture after transplantation, 1 ureter necrosis due to graft rejection, and 2 infection surrounding the renal graft and ureter end necrosis.

RESULTS

Only one patient had the renal graft removed due to massive hemorrhage in an open surgery for correction of urinary obstruction, and the renal function of the graft was preserved in all the other cases after endoscopic or open surgeries. In the follow-up for 0.5 to 3 years after the second surgery, serum creatinine of the patients were maintained within the range of 90-150 micromol/L, without further renal enlargement or exacerbation of renal retention shown by B-mode ultrasonography.

CONCLUSION

Urinary obstruction after renal transplantation is a difficult surgical complication, which can be managed by endoscopic or open surgeries depending on the causes of the obstruction.

摘要

目的

探讨移植肾尿路梗阻的诊断与治疗方法。

方法

对16例移植肾尿路梗阻患者进行回顾性分析,其中输尿管结石5例,膀胱输尿管吻合口狭窄6例,移植后肾盂输尿管连接部狭窄2例,移植肾排斥致输尿管坏死1例,移植肾周围感染及输尿管末端坏死2例。

结果

仅1例患者因尿路梗阻开放手术矫正时大出血而行移植肾切除,其余病例经内镜或开放手术后移植肾功能均得以保留。二次手术后随访0.5至3年,患者血清肌酐维持在90 - 150微摩尔/升范围内,B超检查未显示移植肾进一步增大或肾积水加重。

结论

肾移植后尿路梗阻是一种棘手的手术并发症,可根据梗阻原因采用内镜或开放手术进行处理。

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