Kockelbergh R C, Millar R J, Walker R G, Francis D M
Department of Surgery, Royal Melbourne Hospital, Parkville, Victoria, Australia.
J Urol. 1993 Feb;149(2):366-8. doi: 10.1016/s0022-5347(17)36085-8.
Pyeloureterostomy is the standard procedure for reconstructing renal allograft ureteral complications. Most reports describe an end-to-end technique with or without native nephrectomy. An alternative is an end-to-side anastomosis, leaving the native ureter in continuity. We report our experience with the latter method. Since July 1983, 437 renal transplantations have been performed at our institution. End-to-side pyeloureterostomy has been used in 5 cases for urological reconstruction after renal transplantation following ureteral ischemic necrosis or stenosis. In 1 patient the native kidneys had been removed several years previously but in the remaining 4 the native kidneys were left in situ. There have been no significant complications following this procedure. We believe that by not significantly mobilizing, ligating or dividing the native ureter the chance of anastomotic breakdown due to ischemia may be decreased.
肾盂输尿管吻合术是重建肾移植输尿管并发症的标准术式。大多数报告描述的是采用或不采用自体肾切除的端端吻合技术。另一种方法是端侧吻合，保留自体输尿管的连续性。我们报告我们采用后一种方法的经验。自1983年7月以来，我们机构共进行了437例肾移植手术。端侧肾盂输尿管吻合术已用于5例肾移植术后因输尿管缺血性坏死或狭窄而行泌尿外科重建的患者。1例患者的自体肾已于数年前切除，但其余4例患者的自体肾均予保留。该手术后未出现严重并发症。我们认为，由于不对自体输尿管进行大幅度游离、结扎或离断，因缺血导致吻合口破裂的可能性可能会降低。
