Rajfer J, Koyle M A, Ehrlich R M, Smith R B
J Urol. 1986 Aug;136(2):372-5. doi: 10.1016/s0022-5347(17)44872-5.
The development of ureteral obstruction or ureteral fistula formation in the renal transplant recipient usually requires surgical repair. This involves reconnecting the donor ureter to either the recipient ureter (ureteroureterostomy) or bladder (ureteroneocystostomy), or creating an anastomosis between the renal pelvis and recipient native ureter (pyeloureterostomy). Occasionally, the donor or recipient ureter is absent, necrotic or diseased so that a ureteroureterostomy, ureteroneocystostomy or pyeloureteral anastomosis cannot be performed. In 8 such cases we have performed a direct anastomosis between the donor renal pelvis and recipient bladder (pyelovesicostomy) with a followup of between 2 months and 11 years. In all 8 patients there has been no deterioration in renal function attributed to obstruction at the anastomotic site or to the free reflux between the bladder and renal pelvis. Because of the excellent short-term and long-term results of pyelovesicostomy, this procedure should be considered as an excellent alternative to pyeloureterostomy, ureteroureterostomy and ureteroneocystostomy in the reconstruction of the upper urinary tract of the renal transplant patient.
肾移植受者发生输尿管梗阻或输尿管瘘形成通常需要手术修复。这包括将供体输尿管重新连接到受者输尿管（输尿管输尿管吻合术）或膀胱（输尿管膀胱吻合术），或者在肾盂与受者自身输尿管之间建立吻合（肾盂输尿管吻合术）。偶尔，供体或受者输尿管缺失、坏死或患病，以至于无法进行输尿管输尿管吻合术、输尿管膀胱吻合术或肾盂输尿管吻合术。在8例此类病例中，我们进行了供体肾盂与受者膀胱之间的直接吻合（肾盂膀胱吻合术），随访时间为2个月至11年。所有8例患者的肾功能均未因吻合口处梗阻或膀胱与肾盂之间的自由反流而恶化。由于肾盂膀胱吻合术具有出色的短期和长期效果，在肾移植患者上尿路重建中，该手术应被视为肾盂输尿管吻合术、输尿管输尿管吻合术和输尿管膀胱吻合术的极佳替代方案。
