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移植肾输尿管切除术和原位膀胱切除术后同时行回肠代膀胱术的二次肾移植术

Second Renal Transplantation With Simultaneous Ileal Conduit Creation Following Transplant Nephroureterectomy and Native Cystectomy.

作者信息

Ito Ayato, Ohyama Takehiro, Minamisono Kyoko, Nishida Sho, Iwami Daiki

机构信息

Department of Renal Surgery and Transplantation Jichi Medical University Tochigi Japan.

Department of Urology Iwate Medical University Iwate Japan.

出版信息

IJU Case Rep. 2025 May 14;8(4):377-381. doi: 10.1002/iju5.70044. eCollection 2025 Jul.

Abstract

INTRODUCTION

Postrenal transplant urothelial carcinoma necessitates multidisciplinary treatment. We here report the first case of a patient with transplant ureteral and bladder cancer who underwent transplant nephroureterectomy and cystectomy, followed by a second living donor renal transplantation and ileal conduit creation after a cancer recurrence-free period.

CASE PRESENTATION

A 78-year-old female with end-stage renal disease who had previously undergone living donor renal transplantation presented with gross hematuria. She was diagnosed with transplant ureteral and bladder cancer and subsequently underwent transplant nephroureterectomy and cystectomy. She was immediately reintroduced to hemodialysis. After a 2-year cancer-free period, a second living donor renal transplantation with simultaneous ileal conduit surgery was successfully performed. Currently, the patient remains cancer-free for 2 years following the second renal transplantation.

CONCLUSION

Second renal transplantation and simultaneous ileal conduit creation are alternatives following curative transplant nephrouretero-cystectomy for post-transplant urothelial carcinoma.

摘要

引言

肾移植术后尿路上皮癌需要多学科治疗。我们在此报告首例移植输尿管和膀胱癌患者,该患者接受了移植肾输尿管切除术和膀胱切除术,在无癌复发期后接受了第二次活体供肾移植并创建了回肠代膀胱。

病例介绍

一名78岁终末期肾病女性,此前接受过活体供肾移植,出现肉眼血尿。她被诊断为移植输尿管和膀胱癌,随后接受了移植肾输尿管切除术和膀胱切除术。她立即重新开始血液透析。在无癌2年后,成功进行了第二次活体供肾移植并同时进行了回肠代膀胱手术。目前,该患者在第二次肾移植后已无癌生存2年。

结论

对于移植后尿路上皮癌,在进行根治性移植肾输尿管膀胱切除术后,第二次肾移植并同时创建回肠代膀胱是可供选择的方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4620/12212938/bb1395e0415d/IJU5-8-377-g002.jpg

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