Hauser Stefan, Fechner Guido, Gerhardt Thomas, Klehr Hans-Ulrich, Biermann Katharina, Ellinger Jörg, Müller Stefan C
Department of Urology, University of Bonn, Bonn, Germany.
Transpl Int. 2008 Jul;21(7):696-7. doi: 10.1111/j.1432-2277.2008.00677.x. Epub 2008 Apr 23.
We report on the case of an unexpected blind-ending ureter in a kidney transplant. To our knowledge, this is the first report of a blind-ending ureter in kidney transplantation. The recipient was a 60-year-old woman, with a 6-year history of chronic haemodialysis. During the performance of ureterocystostomy, the ureteric stent could not be placed in the renal pelvis as the ureter, surprisingly, was found as blind-ending in the ureteral sheath. Dissecting the ureteral sheath a second shorter ureter was found and used for ureterocystostomy. The histology reported a normal ureter, which led to a thread of connective tissue. The patient had an uneventful recovery; the creatinine was 1.07 mg/dl at discharge from the hospital. It is mandatory for the transplanting surgeon to be aware of the ureteral variations and the surgeon should be trained in the surgical management of these variations. Accuracy should be ensured when exploring the exact anatomy of the donor organ.
我们报告了一例肾移植中意外发现的盲端输尿管病例。据我们所知,这是肾移植中盲端输尿管的首例报告。受者为一名60岁女性,有6年慢性血液透析病史。在进行输尿管膀胱吻合术时,由于输尿管令人惊讶地在输尿管鞘内呈盲端,输尿管支架无法置入肾盂。解剖输尿管鞘时发现了第二条较短的输尿管,并将其用于输尿管膀胱吻合术。组织学报告显示输尿管正常,仅导致一条结缔组织索。患者恢复顺利;出院时肌酐水平为1.07mg/dl。移植外科医生必须了解输尿管的变异情况,并且应该接受处理这些变异的手术管理培训。在探查供体器官的确切解剖结构时应确保准确性。