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肾移植术后泌尿外科并发症管理的微创方法:单中心经验

Minimally invasive approach for the management of urological complications after renal transplantation: single center experience.

作者信息

Özkaptan Orkunt, Sevinc Cuneyd, Balaban Muhsin, Karadeniz Tahir

机构信息

Liv Hospital Ulus, Istanbul, Turkey -

Medicana International Hospital, Istanbul, Turkey.

出版信息

Minerva Urol Nefrol. 2018 Aug;70(4):422-428. doi: 10.23736/S0393-2249.18.03078-3. Epub 2018 Mar 28.

Abstract

BACKGROUND

The aim of the study was to characterise urological complications after renal transplantation and to evaluate the role of minimally invasive management for urological complications.

METHODS

A total of 920 kidney transplantations were performed between 2008 and 2015. All patients were followed up for at least 1 year after transplantation. Complications regarded as urological were urinary leakage, ureteral stricture, urinary malignancy, bladder outlet obstruction (BOO) and urinary calculi. We evaluated data from the time of occurrence of urological complications and the type of the management prescribed.

RESULTS

Among 920 transplantations performed in our clinic, 41 (4.4%) urological complications arose. Twenty (48.8%) of the complications occurred during the first 3 months and 21 (51.2%) occurred after 3 months, postoperatively. Ureteral strictures were found in 14 (34.1%) patients, urinary tract stones in seven (17%), BOO in 6 (14.6%) and urinary leakage was observed in 5 (12.1%) patients. Ureteral stricture was managed with endoscopic approach in eight (61.3%) patients. Urinary tract stones and urinary leakage were managed in 7 (100%) and 4 (75%) patients with endoscopic approach. Overall 29 (70.7%) of 41 urological complications were managed with endourological approaches.

CONCLUSIONS

It is likely that the importance of open surgery could decrease in the future. Endoscopic management of urological complications have come to have an important role in the treatment of urological complications after transplantation.

摘要

背景

本研究的目的是描述肾移植术后的泌尿系统并发症,并评估微创管理在泌尿系统并发症中的作用。

方法

2008年至2015年间共进行了920例肾移植手术。所有患者在移植后至少随访1年。被视为泌尿系统的并发症包括尿漏、输尿管狭窄、泌尿系统恶性肿瘤、膀胱出口梗阻(BOO)和尿路结石。我们评估了泌尿系统并发症发生时的数据以及所采用的治疗方式类型。

结果

在我们诊所进行的920例移植手术中,出现了41例(4.4%)泌尿系统并发症。其中20例(48.8%)并发症发生在术后前3个月,21例(51.2%)发生在术后3个月后。14例(34.1%)患者发现输尿管狭窄,7例(17%)患者有尿路结石,6例(14.6%)患者有膀胱出口梗阻,5例(12.1%)患者观察到尿漏。8例(61.3%)输尿管狭窄患者采用内镜治疗。7例(100%)尿路结石患者和4例(75%)尿漏患者采用内镜治疗。41例泌尿系统并发症中,总体有29例(70.7%)采用腔内泌尿外科方法治疗。

结论

未来开放手术的重要性可能会降低。内镜管理在移植术后泌尿系统并发症的治疗中已开始发挥重要作用。

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