Tahir W, Hakeem A, White A, Irving H C, Lloyd S N, Ahmad N
Division of Surgery, Department of Transplantation, St James's University Hospital, Leeds, United Kingdom.
Am J Transplant. 2014 Aug;14(8):1927-30. doi: 10.1111/ajt.12778. Epub 2014 Jul 1.
Ureteric stricture is the most common urological complication following renal transplantation. Management often involves endo-urological interventions and open surgery. The definitive treatment is surgical reconstruction to restore continuity. Where this is not possible or contra-indicated and a stent cannot be placed in the ureter, an extra-anatomic stent (EAS) could be used to bypass a complete ureteric obstruction. Using an existing nephrostomy tract, a percutaneous stent is placed in the kidney and is tunneled under the skin into the bladder establishing extra-anatomical urinary drainage. We report the use of a novel EAS system in a patient with transplant ureteric stricture when antegrade stent placement or surgical reconstruction was not possible.
输尿管狭窄是肾移植后最常见的泌尿系统并发症。治疗通常包括腔内泌尿外科干预和开放手术。最终治疗方法是进行手术重建以恢复连续性。若无法进行或存在禁忌且不能在输尿管内放置支架时,可使用解剖外支架(EAS)来绕过完全性输尿管梗阻。利用现有的肾造瘘通道,将经皮支架置入肾脏,然后经皮下隧道引入膀胱,建立解剖外尿液引流。我们报告了在一位无法进行顺行支架置入或手术重建的移植输尿管狭窄患者中使用新型EAS系统的情况。