Jenjitranant Pocharapong, Tansakul Pasu, Sirisreetreerux Pokket, Leenanupunth Charoen, Jirasiritham Sopon
Division of Urology, Department of Surgery, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Division of Vascular and Transplant Surgery, Department of Surgery, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Res Rep Urol. 2020 Oct 28;12:509-516. doi: 10.2147/RRU.S272899. eCollection 2020.
Kidney transplantation is one of the best treatment options for end-stage renal disease with an incidence of urologic complications of 2.5 to 30%. One of the most serious and frequent urological complications is urinary leakage from ureteroneocystostomy anastomosis. The purpose of this study was to evaluate risk factors of urinary leakage from ureteroneocystostomy anastomosis after kidney transplantation.
A retrospective study was performed on patients who received kidney transplantation and were diagnosed with urinary leakage thereafter based on renal scan or drain creatinine per serum creatinine compared with patients in control group. Risk factor assessment was based on inpatient and outpatient information from hospital database.
From 459 patients who received kidney transplantation in 2016-2018, there were 20 patients who were diagnosed with urinary leakage after they underwent ureteroneocystostomy anastomosis. The significant risk factors for anastomosis leakage were size of suture materials and duration of ureteral stent insertion. No statistically significant difference in other factors such as underlying disease, surgical technique or duration of urinary catheter was found. About overall urological complication, gender and body mass index significantly affected the outcome.
The rate of urinary leakage complications was found to be about 4.36%. The risk factors of overall complication comprised gender and body mass index. Although a lot of previous studies revealed many risk factors that could affect urinary leakage, size of suture materials and duration of ureteral stent insertion were the significant risk factors in our study. Proper consideration should be given to the size of suture materials and optimal duration of ureteral stent.
肾移植是终末期肾病最佳治疗方案之一，其泌尿系统并发症发生率为2.5%至30%。最严重且常见的泌尿系统并发症之一是输尿管膀胱吻合口漏尿。本研究旨在评估肾移植术后输尿管膀胱吻合口漏尿的危险因素。
对接受肾移植且之后根据肾扫描或引流肌酐与血清肌酐比值诊断为漏尿的患者进行回顾性研究，并与对照组患者进行比较。危险因素评估基于医院数据库中的住院和门诊信息。
在2016年至2018年接受肾移植的459例患者中，有20例在输尿管膀胱吻合术后被诊断为漏尿。吻合口漏的显著危险因素是缝合材料的尺寸和输尿管支架置入时间。在基础疾病、手术技术或导尿时间等其他因素方面未发现统计学上的显著差异。关于总体泌尿系统并发症，性别和体重指数对结果有显著影响。
发现漏尿并发症发生率约为4.36%。总体并发症的危险因素包括性别和体重指数。尽管之前许多研究揭示了许多可能影响漏尿的危险因素，但在我们的研究中，缝合材料的尺寸和输尿管支架置入时间是显著危险因素。应适当考虑缝合材料的尺寸和输尿管支架的最佳置入时间。
