Halstuch Daniel, Ehrlich Yaron, Shenhar Chen, Mano Roy, Baniel Jack, Margel David, Lifshitz David A
Division of Urology, Rabin Medical Center, Petah Tikva, Israel.
Division of Urology, Rabin Medical Center, Petah Tikva, Israel; Division of Surgery, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Urology. 2018 Jan;111:220-224. doi: 10.1016/j.urology.2017.09.012. Epub 2017 Sep 28.
To present a reliable technique for fluoroscopic controlled, large-bore, ureteral stent placement and exchange in transplant kidneys with persistent ureterovesical strictures.
We reviewed the medical charts of all patients who underwent kidney transplant with persistent ureterovesical strictures who underwent ureteral stent placement or exchange at our institution between 2005 and 2015 using the new technique. Clinical characteristics and treatment outcomes of the study cohort were analyzed.
Ureteral stent insertion or stent exchange, using this technique, was performed in 32 renal transplant units. Median operating time was 24 minutes (interquartile range, 21-36.75 minutes). The overall success rate of the technique at first attempt was 96.9%. In 1 patient, drainage of the transplanted kidney with a nephrostomy tube was indicated after procedure failure. No other local or systemic complications were encountered, and no stent encrustation was noted in this cohort of patients. Renal function remained stable in all patients during a median follow-up of 59 months (interquartile range, 28-61 months).
Herein, we present in detail a step-by-step technique for the insertion and exchange of large-bore ureteral stents in transplanted kidneys. The technique was shown to be safe, effective, and highly successful.
介绍一种在荧光透视控制下，为存在持续性输尿管膀胱狭窄的移植肾进行大口径输尿管支架置入及更换的可靠技术。
我们回顾了2005年至2015年间在我院采用新技术进行输尿管支架置入或更换的所有存在持续性输尿管膀胱狭窄的肾移植患者的病历。分析了研究队列的临床特征和治疗结果。
采用该技术在32个肾移植单元进行了输尿管支架置入或支架更换。中位手术时间为24分钟（四分位间距为21 - 36.75分钟）。该技术首次尝试的总体成功率为96.9%。1例患者在手术失败后需行肾造瘘管引流移植肾。该队列患者未出现其他局部或全身并发症，也未发现支架结壳。在中位随访59个月（四分位间距为28 - 61个月）期间，所有患者的肾功能保持稳定。
在此，我们详细介绍了一种为移植肾插入和更换大口径输尿管支架的分步技术。该技术被证明是安全、有效且成功率高的。
