Isa W A, Robles J E, Rosell D, Aguera L G, de Castro F, Sánchez P L, Zudaire J J, Errasti P, Berián J M
Departamento de Urología y Servicio de Nefrología, Facultad de Medicina, Universidad de Navarra, Pamplona, España.
Actas Urol Esp. 1991 Jul-Aug;15(4):351-6.
We describe the urological complications occurred in 237 patients undergoing cadaveric renal transplant in 13 years. Two techniques of extravesical ureterocystoneostomy were used. Thirty patients (13%) presented 35 (15%) urological complications: 23 (9.7%) urinary fistula and 12 (5.1%) ureteral stenosis. The vast majority (80%) were early complications (before 90 days): 82% fistulas and 18% stenosis. All early complications were identified as technical deficiencies; all late complications were obstructive in nature. A new ureteral reimplant was performed in 15 patients, with successful results in 14. Six patients underwent nephrectomy and pyelostomy, 2 of these required a second operation. Seven patients underwent endo-urological procedures with good results. Three patients undergoing conservative treatment for urinary fistula required surgical drainage of an infected urinoma. No statistical difference was observed in the survival rates of both the grafts and the patients presenting or not urinary complications.
我们描述了13年间237例接受尸体肾移植患者发生的泌尿系统并发症。采用了两种膀胱外输尿管膀胱吻合术。30例患者(13%)出现了35例(15%)泌尿系统并发症:23例(9.7%)尿瘘和12例(5.1%)输尿管狭窄。绝大多数(80%)为早期并发症(90天之前):82%为尿瘘,18%为狭窄。所有早期并发症均被认定为技术缺陷;所有晚期并发症本质上均为梗阻性。15例患者进行了输尿管再植术,14例成功。6例患者接受了肾切除术和肾盂造瘘术,其中2例需要二次手术。7例患者接受了腔内泌尿外科手术,效果良好。3例因尿瘘接受保守治疗的患者需要对感染性尿瘤进行手术引流。出现或未出现泌尿系统并发症的移植物和患者的生存率均未观察到统计学差异。