Diagnosis and surgical treatment of long distance ureteral stenosis after kidney transplantation
10.3760/cma.j.issn.0254-1785.2010.08.011
- VernacularTitle:肾移植术后长段输尿管狭窄的诊断与开放性手术治疗
- Author:
Tongyi MEN
;
Xiaoming ZHANG
;
Jianning WANG
;
Xianduo LI
;
Jiwei YANG
;
Zhensheng WANG
- Publication Type:Journal Article
- Keywords:
Kidney transplantation;
Ureteral stenosis;
Surgical operation
- From:
Chinese Journal of Organ Transplantation
2010;31(8):485-487
- CountryChina
- Language:Chinese
-
Abstract:
Objective To summarize the experience of diagnosis and surgical treatment of long distance ureteral stenosis after kidney transplantation. Methods Eleven cases of ureteral stenosis following renal transplantation were analyzed. Ureteral stenosis happened between 2-6 months after transplantation. The clinical manifestations were as follows: serum creatinine and weight elevated,urine decreased, graft area swelling. All cases were diagnosed using ultrasound, MRU or CTU. The ureteral obstruction length was 3-7 cm. In 5 patients a Boari flap technique was used, and the native ureter for pyelo-ureterostomy was used in 2 patients. Four patients were subjected to surgical operation using the native ureter for uretero-ureterostomy. Results All of the surgical treatments were successful and no operation-related complications occurred. The operation time was 2. 5 to 4 h.After reconstruction of ureter-bladder anastomosis, the urine was increased, the serum creatinine decreased to 75-156μmol/L, and uronephrosis disappeared or alleviated. The follow-up lasting 8 to 62 months showed no recurrence in all the cases. Conclusion For such cases, ultrasound should be routinely used for the possibility of stenosis. CTU or MRU is important to know the obstruction length and position. For the patients with long distance ureteral stenosis after kidney transplantation,surgical correction is the first choice.
