Narita Takuma, Hatakeyama Shingo, Koie Takuya, Hosogoe Shogo, Matsumoto Teppei, Soma Osamu, Yamamoto Hayato, Yoneyama Tohru, Tobisawa Yuki, Yoneyama Takahiro, Hashimoto Yasuhiro, Ohyama Chikara
Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, 036-8562, Japan.
Department of Advanced Transplant and Regenerative Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
BMC Urol. 2017 Aug 31;17(1):72. doi: 10.1186/s12894-017-0263-x.
Urinary tract obstruction and postoperative hydronephrosis are risk factor for renal function deterioration after orthotopic ileal neobladder construction. However, reports of relationship between transient hydronephrosis and renal function are limited. We assess the influence of postoperative transient hydronephrosis on renal function in patients with orthotopic ileal neobladder construction.
Between January 2006 and June 2013, we performed radical cystectomy in 164 patients, and 101 received orthotopic ileal neobladder construction. This study included data available from 64 patients with 128 renal units who were enrolled retrospectively. The hydronephrosis grade of each renal unit scored 0-4. The patients were divided into 4 groups according to the grade of hydronephrosis: control, low, intermediate, and high. The grade of postoperative hydronephrosis was compared with renal function 1 month and 1 year after surgery.
There were no significant differences in renal function before surgery between groups. One month after surgery, the presence of hydronephrosis was significantly associated with decreased renal function. However, 1 year after urinary diversion hydronephrosis grades were improved significantly, and renal function was comparable between groups. Postoperative hydronephrosis at 1 month had no significant influence on renal function 1 year after ileal neobladder construction. Limitations include retrospective design, short follow-up periods, and a sample composition.
The presence of transient hydronephrosis immediately after surgery may have limited influence on renal function 1 year after ileal neobladder construction.
尿路梗阻和术后肾积水是原位回肠新膀胱构建术后肾功能恶化的危险因素。然而,关于短暂性肾积水与肾功能之间关系的报道有限。我们评估了原位回肠新膀胱构建术后短暂性肾积水对患者肾功能的影响。
2006年1月至2013年6月期间,我们对164例患者实施了根治性膀胱切除术,其中101例接受了原位回肠新膀胱构建术。本研究纳入了64例患者共128个肾单位的回顾性数据。每个肾单位的肾积水程度评分为0 - 4分。根据肾积水程度将患者分为4组:对照组、轻度、中度和重度。比较术后1个月和1年时肾积水程度与肾功能的关系。
各组术前肾功能无显著差异。术后1个月,肾积水的存在与肾功能下降显著相关。然而,尿流改道1年后肾积水程度显著改善,各组间肾功能相当。回肠新膀胱构建术后1个月时的肾积水对1年后的肾功能无显著影响。局限性包括回顾性设计、随访期短和样本构成。
术后即刻出现的短暂性肾积水对回肠新膀胱构建术后1年的肾功能影响可能有限。