Rekouna Konstantina, Dimitrokallis Nikolaos, Kypraios Charalampos, Kontothanasis Dimitrios, Vougas Vasileios
1st Department of Surgery and Transplantation, Evangelismos General Hospital, Athens, GRC.
Department of Urology, Evangelismos General Hospital, Athens, GRC.
Cureus. 2023 Apr 24;15(4):e38036. doi: 10.7759/cureus.38036. eCollection 2023 Apr.
Iatrogenic ureteral injuries are a significant complication during pelvic surgery, requiring a multidisciplinary approach for optimal repair. When a ureteral injury is suspected postoperatively, abdominal imaging is essential to determine the type of injury and thus the timing and method of reconstruction. That can be performed either by a CT pyelogram or by an ureterography-cystography with or without ureter stenting. Although technological advancements and minimally invasive surgery have been gaining ground over open complex surgeries, renal autotransplantation is a well-established technique of proximal ureter repair and should be highly considered when dealing with a severe injury. We hereby report the case of a patient with a recurrent ureter injury and multiple laparotomies treated with autotransplantation, without any major morbidities or change in their quality of life. In every case, a personalized approach for each patient and consultation with experienced transplant experts (surgeons, urologists, and nephrologists) is advised.
医源性输尿管损伤是盆腔手术期间的一种严重并发症,需要多学科方法进行最佳修复。术后怀疑有输尿管损伤时,腹部影像学检查对于确定损伤类型以及重建的时机和方法至关重要。这可以通过CT肾盂造影或输尿管造影-膀胱造影来进行,有无输尿管支架置入均可。尽管技术进步和微创手术在复杂开放手术中逐渐占据优势,但自体肾移植是一种成熟的近端输尿管修复技术,在处理严重损伤时应予以高度考虑。我们在此报告一例复发性输尿管损伤且多次开腹手术的患者接受自体肾移植治疗的病例,术后无任何重大并发症,生活质量也未改变。在每种情况下,建议针对每位患者采取个性化方法,并咨询经验丰富的移植专家(外科医生、泌尿科医生和肾病科医生)。