Baquero A, Ginsberg P C, Kaschak D, Raja R, Schneeberg A, Solish L, Bannett A D
J Urol. 1985 Mar;133(3):386-7. doi: 10.1016/s0022-5347(17)48989-0.
Ureteroneocystostomy was used as the primary method of urinary tract reconstruction in 282 allograft renal transplants at our center since 1965. A nonrefluxing anastomosis was incorporated whenever possible. Seven patients who suffered major urological complications involving the ureteroneocystostomy required pyeloureterostomy as the method of repair using the patient's distal native ureter. No ipsilateral nephrectomy was performed and simple ligation of the native ureter with nonabsorbable suture was accomplished. Of the 7 patients 3 suffered hydronephrosis of the native kidney. None of these patients had signs or symptoms secondary to acute and chronic ureteral occlusion. Our experience suggests that intentional ligation of the native ureter during pyeloureterostomy does not result in increased morbidity to the transplant patient, and that the need for ipsilateral nephrectomy with its own added morbidity may not be necessary.
自1965年以来，在我们中心的282例同种异体肾移植中，输尿管膀胱再植术被用作尿路重建的主要方法。只要有可能，就采用抗反流吻合术。7例输尿管膀胱再植术出现严重泌尿系统并发症的患者，需要采用肾盂输尿管吻合术，利用患者远端的自体输尿管进行修复。未进行同侧肾切除术，而是用不可吸收缝线对自体输尿管进行了简单结扎。这7例患者中有3例出现了自体肾积水。这些患者均没有因急慢性输尿管梗阻而出现的体征或症状。我们的经验表明，肾盂输尿管吻合术中对自体输尿管进行有意结扎不会增加移植患者的发病率，而且进行同侧肾切除术及其带来的额外发病率可能没有必要。
