Higgins Margaret M, Walker Jonathan P, Daily Michael F, Gupta Shubham
University of Kentucky, Department of Urology, 800 Rose Street, MS283, Lexington, KY 40536-0298, USA.
University of Kentucky, Department of Transplant Surgery, 800 Rose Street, C453, Lexington, KY 40536-0298, USA.
Urol Case Rep. 2017 May 11;13:74-76. doi: 10.1016/j.eucr.2017.03.028. eCollection 2017 Jul.
A 59-year-old male developed a proximal stricture of his transplant ureter ten years after a living donor renal transplant. Endoscopic management was unsuccessful, and the patient was temporized with percutaneous nephrostomy tubes for months. Eventually, it became clear he would require surgical revision. Intraoperatively, complete fibrosis of the renal hilum, and intrarenal location of the pelvis precluded the planned pyelovesicostomy. A successful open vesicocalicostomy was performed, anastomosing a bladder flap to a lower pole calix. The patient remains recurrence free after 6 months of follow-up.
一名59岁男性在活体供肾肾移植十年后出现移植输尿管近端狭窄。内镜治疗失败，患者通过经皮肾造瘘管暂时处理了数月。最终，明确他需要进行手术修复。术中发现肾门完全纤维化，肾盂位于肾内，使得计划中的肾盂膀胱吻合术无法进行。于是成功实施了开放膀胱肾盂吻合术，将膀胱瓣与下极肾盏吻合。随访6个月，患者无复发。
