Shrestha B M, Darby C R, Moore R H
Renal Transplant Unit, University Hospital of Wales, Heath Park, Cardiff, UK.
Kathmandu Univ Med J (KUMJ). 2006 Oct-Dec;4(4):409-14.
Ureteric complications (UCs) following renal transplantation (RT) cause significant morbidity and ureteric stents are employed to bridge the vesico-ureteric anastomosis with a view to preventing these complications. The purpose of this study was to examine the incidence of UCs and outcomes following RT in both stented (STG) and non-stented groups (NSTG) of RT patients.
This is a retrospective study of a cohort of 650 consecutive RTs [STG (N=267; 41%) and NSTG (N=383; 59%)] performed over a period of 8 years, where the data were retrieved from a prospectively maintained computerised database and case-notes.
The overall incidence of UCs was 6.5% (42/650), which consisted of ureteric obstruction (UO) in 4.3% (28) and ureteric leak (UL) in 2.2%(14) of patients. The incidence of UO was significantly high in the NSTG compared to the STG (6.3% vs.1.5%; P=0.002). However, the incidence of UL (3.4% vs.1.3%; P=0.1) and post-transplant urinary tract infection (UTI) (44% vs.41%; P=0.57) were not significantly different between the STG and NSTG groups. UO and UL were associated with significantly high incidence of UTI (P=0.001 and 0.01, respectively). All UCs were managed successfully without allograft loss.
Routine stenting of ureteric anastomosis resulted in reduced incidence of UO without concomitant increased risk of UTI.
肾移植（RT）后输尿管并发症（UCs）会导致严重发病，输尿管支架用于连接膀胱输尿管吻合口，以预防这些并发症。本研究的目的是检查肾移植患者中支架置入组（STG）和非支架置入组（NSTG）的输尿管并发症发生率及肾移植后的结局。
这是一项对8年间连续进行的650例肾移植病例（STG组267例，占41%；NSTG组383例，占59%）的回顾性研究，数据从一个前瞻性维护的计算机数据库和病历中获取。
输尿管并发症的总体发生率为6.5%（42/650），其中输尿管梗阻（UO）发生率为4.3%（28例），输尿管漏（UL）发生率为2.2%（14例）。与STG组相比，NSTG组的输尿管梗阻发生率显著更高（6.3%对1.5%；P=0.002）。然而，STG组和NSTG组之间的输尿管漏发生率（3.4%对1.3%；P=0.1）和移植后尿路感染（UTI）发生率（44%对41%；P=0.57）无显著差异。输尿管梗阻和输尿管漏与尿路感染的高发生率显著相关（分别为P=0.001和0.01）。所有输尿管并发症均成功处理，未出现移植肾丢失。
输尿管吻合口常规置入支架可降低输尿管梗阻的发生率，且不会增加尿路感染的风险。
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