Department of Kidney Transplantation, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China.
Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China.
Int Urol Nephrol. 2023 Sep;55(9):2193-2203. doi: 10.1007/s11255-023-03669-z. Epub 2023 Jun 12.
To explore the risk factors of ureteral stricture in transplant kidney and the clinical effects of different treatment methods.
The 62 patients with transplant kidney ureteral stenosis as the experimental group, and another group of recipients from the same donor as the control group (n = 59 cases). The risk factors for ureteral stricture and the survival rate of transplant kidney were analyzed and compared. The 62 patients were divided into open operation, luminal operation, and magnetic compression anastomosis (MCA) operation group. The effect of the operation and the survival rate of transplant kidney among the three groups were compared.
In our study, we found that the above differences were statistically significant in clinical data such as gender, multiple donor renal arteries, history of infection, and delayed graft function (DGF) between the two groups (P < 0.05). Urinary tract infection and DGF history were the independent risk factors for the development of ureteral stricture. The open operation had the best treatment effect and the survival rate of the transplant kidney, followed by the MCA, the stricture recurrence rate in the luminal operation was the highest.
The ureteral stricture has a negative correlation with the long-term survival rate of the transplant kidney, the curative rate and long-term effect of open surgery are the best, stricture recurrence rate of luminal surgery is high, and it may require multiple operations in the future, the MCA is a new breakthrough and innovation in the treatment of ureteral stricture.
探讨移植肾输尿管狭窄的危险因素及不同治疗方法的临床效果。
选取 62 例移植肾输尿管狭窄患者作为实验组,另选同一供体来源的 59 例受者作为对照组。分析并比较两组患者输尿管狭窄的危险因素及移植肾存活率。将 62 例患者分为开放手术组、腔内手术组、磁压迫吻合术(MCA)组,比较三组手术效果及移植肾存活率。
在本研究中,我们发现两组患者在性别、多供肾动脉、感染史和延迟肾功能恢复(DGF)等临床资料上存在显著差异(P<0.05)。尿路感染和 DGF 病史是输尿管狭窄发生的独立危险因素。开放手术治疗效果最佳,移植肾存活率最高,MCA 次之,腔内手术狭窄复发率最高。
输尿管狭窄与移植肾长期存活率呈负相关,开放手术的治愈率和长期效果最佳,腔内手术狭窄复发率较高,可能需要多次手术,MCA 是治疗输尿管狭窄的新突破和创新。