Bodie B, Novick A C, Rose M, Straffon R A
J Urol. 1986 Dec;136(6):1187-9. doi: 10.1016/s0022-5347(17)45278-5.
From 1970 to 1984 renal autotransplantation was performed on 23 patients to replace all or a major portion of the ureter. The conditions necessitating ureteral replacement were postoperative ureteral injury in 16 cases, recurrent renal colic in 4, urinary undiversion in 2 and an atonic ureter in 1. Six patients presented with a solitary kidney and 1 underwent staged bilateral autotransplantation. After autotransplantation urinary continuity was restored by ureteroneocystostomy in 11 patients, pyelovesicostomy in 7, ureteroureterostomy in 2, pyeloureterostomy in 2 and ureterosigmoidostomy in 1. Postoperatively, there was no mortality and all but 1 of the autotransplanted kidneys functioned immediately. Two kidneys required removal postoperatively owing to bleeding. Currently, 20 patients are alive with functioning renal autotransplants at intervals of 1.5 to 14 years. The current serum creatinine level in these patients ranges from 1.1 to 2.2 mg. per dl., which in each case is improved or stable compared to the preoperative determination. Only 1 patient has experienced chronic bacteriuria. We conclude that renal autotransplantation provides excellent long-term treatment for patients who require ureteral replacement.
1970年至1984年间，对23例患者进行了肾自体移植，以替代全部或大部分输尿管。需要进行输尿管替代的情况包括：术后输尿管损伤16例，复发性肾绞痛4例，尿流改道2例，输尿管无力1例。6例患者为单肾，1例接受了分期双侧自体移植。自体移植后，11例患者通过输尿管膀胱吻合术恢复了尿路连续性，7例通过肾盂膀胱吻合术，2例通过输尿管输尿管吻合术，2例通过肾盂输尿管吻合术，1例通过输尿管乙状结肠吻合术。术后无死亡病例，除1例自体移植肾外，其余均立即发挥功能。2例肾脏因出血术后需要切除。目前，20例患者存活，自体移植肾发挥功能，时间间隔为1.5至14年。这些患者目前的血清肌酐水平在每分升1.1至2.2毫克之间，与术前测定相比，每种情况均有所改善或稳定。只有1例患者出现慢性菌尿。我们得出结论，肾自体移植为需要输尿管替代的患者提供了出色的长期治疗效果。
