Löbermann H, Dostal G, Schreiber B, Eigler F W
Langenbecks Arch Chir. 1979 Aug;348(4):269-75. doi: 10.1007/BF01317613.
Ureteral complications occurred in 23 cases after 225 renal transplantations. The complications consisted of 17 urinary fistulas and 6 stenoses of the ureter. Fourteen of the urinary fistulas were successfully treated by conservative management. Two transplants were lost secondary to operation because of ureteral obstruction. Factors contributing to ureteral leakage were the technique of ureteral anastomosis, the handling of the donor ureter during donor nephrectomy and possibly ureteral necrosis by rejection crises. Ureteral stenosis and rejection crisis may have the same symptoms. Urinary fistulas can easily be observed by the urine extravasation. The treatment of urinary fistulas can be managed only by replacing the suprapubical drainage. The stenosis of ureter with subsequent deterioration of graft function needs an operation with the danger of loss of the transplanted kidney.
225例肾移植术后发生输尿管并发症23例。并发症包括17例尿瘘和6例输尿管狭窄。14例尿瘘经保守治疗成功治愈。2例移植肾因输尿管梗阻手术失败。输尿管吻合技术、供肾切除术中供体输尿管的处理以及可能因排斥反应导致的输尿管坏死是导致输尿管漏的因素。输尿管狭窄和排斥反应可能有相同的症状。尿瘘可通过尿液外渗轻易观察到。尿瘘的治疗只能通过更换耻骨上引流来处理。输尿管狭窄并随后移植肾功能恶化需要手术治疗,但存在移植肾丢失的风险。