Alshamsi Iman, Alshamsi Hefsa, Al Falahi Salamah, Sharma Ajay, Halawa Ahmed
Division of Nephrology, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates; Faculty of Health and Science, Institute of Learning and Teaching, University of Liverpool, Liverpool, England.
Faculty of Health and Science, Institute of Learning and Teaching, University of Liverpool; Renal Transplantation Department, Royal Liverpool University Hospitals, Liverpool, England.
Saudi J Kidney Dis Transpl. 2019 May-Jun;30(3):564-570. doi: 10.4103/1319-2442.261328.
Renal transplant is the treatment of choice for end-stage renal disease. Perirenal fluid collections are a common surgical complication postrenal transplant that may lead to early graft loss, considerable morbidity, and excess financial loss, if not diagnosed and managed early. The causes of posttransplant fluid collections are urinary leak, lymphocele, hematoma, and seroma, which can be further complicated by abscess formation if becomes infected. Urine leak is considered the most common urological complication postrenal transplant. Diagnosis can be made by biochemical analysis of the fluid drainage with the simultaneous comparison to that of serum. Radiological imaging is also essential for confirming the diagnosis of urinary leak that may not necessarily identify the site of the leak. The management of urinary leak is usually surgical unless the leak is small. The choice of surgery depends on the location of the leak, the vascularization of the involved ureter, and the presence of any complications caused by the leak. This article reviews the differential diagnoses of perirenal fluid collections in postrenal transplant period and focuses on the clinical assessment of urinoma and management options according to the latest evidence-based medicine.
肾移植是终末期肾病的首选治疗方法。肾周积液是肾移植术后常见的外科并发症，如果不及早诊断和处理，可能导致早期移植物丢失、严重的发病率以及额外的经济损失。移植后积液的原因包括尿漏、淋巴囊肿、血肿和血清肿，如果发生感染，可能会进一步并发脓肿形成。尿漏被认为是肾移植术后最常见的泌尿外科并发症。通过对引流液进行生化分析并与血清进行同步比较可做出诊断。放射影像学对于确诊尿漏也至关重要，但其不一定能确定漏口的位置。除非漏口较小，尿漏的处理通常采用手术治疗。手术方式的选择取决于漏口的位置、受累输尿管的血供以及漏口引起的任何并发症。本文综述了肾移植术后肾周积液的鉴别诊断，并根据最新的循证医学重点介绍了尿瘤的临床评估和处理方案。
