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比较肾移植受者的两种输尿管再植技术。

Comparing two ureter reimplantation techniques in kidney transplant recipients.

作者信息

Gurkan Alihan, Yakupoglu Yarkin K, Dinckan Ayhan, Erdogdu Tibet, Tuncer Murat, Erdoğan Okan, Demirbas Alper, Akaydin Mustafa

机构信息

Department of General Surgery, Akdeniz University Transplantation Center, Antalya 07059, Turkey.

出版信息

Transpl Int. 2006 Oct;19(10):802-6. doi: 10.1111/j.1432-2277.2006.00348.x.

Abstract

We compared the incidence of urological and anastomotic complications for the ureteroureterostomy and Lich-Gregoir techniques in kidney transplant recipients. Between May 2003 and February 2004, 75 kidney transplant recipients from living donors were divided into two similar groups to receive ureteroureterostomy (n = 41, 28 male, 13 female) and Lich-Gregoir techniques (n = 34, 24 male, 10 female) for ureteral reimplantation. Patients with vesicoureteral reflux (VUR) to the native kidneys were excluded from the study. The urological complications included complicated hematuria, ureteral stenosis, symptomatic VUR, recurrent urinary tract infection (UTI). There was no statistical significance between two groups in terms of gender, age, end-stage renal disease etiology, human leucocyte antigen (HLA) mismatch numbers, type and duration of dialysis, and cold ischemia time. The incidence of urologic and anastomotic complications was 12%. Complications in the Lich-Gregoir group included symptomatic VUR in 8.8% and stent migration in 2.9% of cases. Complications observed in the ureteroureterostomy group were ureteral stricture 7.3% and complicated hematuria in 4.9% of cases. However, symptomatic reflux was not observed in the ureteroureterostomy group. UTI frequency was similar in both groups. Ureteroureterostomy can be safely performed as a primary choice in kidney transplant recipients.

摘要

我们比较了肾移植受者中输尿管输尿管吻合术和利奇-格雷戈尔技术的泌尿系统及吻合口并发症发生率。在2003年5月至2004年2月期间,75例来自活体供者的肾移植受者被分为两个相似的组,分别接受输尿管输尿管吻合术(n = 41,男28例,女13例)和利奇-格雷戈尔技术(n = 34,男24例,女10例)进行输尿管再植。患有原发性膀胱输尿管反流(VUR)的患者被排除在研究之外。泌尿系统并发症包括复杂性血尿、输尿管狭窄、有症状的VUR、复发性尿路感染(UTI)。两组在性别、年龄、终末期肾病病因、人类白细胞抗原(HLA)错配数、透析类型和时长以及冷缺血时间方面无统计学差异。泌尿系统及吻合口并发症的发生率为12%。利奇-格雷戈尔组的并发症包括8.8%的患者出现有症状的VUR,2.9%的病例出现支架移位。输尿管输尿管吻合术组观察到的并发症为7.3%的病例出现输尿管狭窄,4.9%的病例出现复杂性血尿。然而,输尿管输尿管吻合术组未观察到有症状的反流。两组的UTI发生率相似。输尿管输尿管吻合术可作为肾移植受者的首选安全术式。

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