Endoscopic incision in the treatment of ureterovesical anastomosis site obstruction in transplanted kidneys
10.3760/cma.j.issn.1000-6702.2009.05.011
- VernacularTitle:腔内切开治疗移植肾输尿管膀胱吻合口梗阻
- Author:
Xun LI
;
Zhangqun YE
;
Zhaohui HE
;
Siwei ZHOU
;
Yongzhong HE
;
Gang FENG
- Publication Type:Journal Article
- Keywords:
Kidney transplantation;
Ureteral obstruction;
Stomas;
Endoscopic therapy
- From:
Chinese Journal of Urology
2009;30(5):324-327
- CountryChina
- Language:Chinese
-
Abstract:
Objective To report the clinical outcomes of applying endoscopic incision in the treatment of ureterovesical anastomosis site obstruction in transplanted kidneys. Methods Between February 2001 and April 2008, 13 men and 5 women with ureterovesical anastomotic site obstruction in their transplanted kidneys were treated by endoscopic incision with electrocautery or holmium: YAG laser. After the anastomosis was completely resected, two Double-J stents were placed in the ureter for 6-8 weeks. During follow-up, renal function, ultrasound examination and wash-out renal scintig-raphy were performed every month for the first 6 months, then every 3 months. Results Total 25 procedures of endoureterotomy were performed and all procedures resulted in successful incision of the obstruction. No complication was recorded during or after the procedure. At the mean follow-up of 51 months (range 4-90 months), 5 patients presented with recurred obstructive uropathy immediately after the Double-J stent removal and finally underwent open surgical correction. Conclusions Endo-scopic incision is safe and effective in the treatment of ureterovesical anastomosis site obstruction in transplanted kidney. However, open surgical reconstruction should be considered if endoscopic inci-sion procedure has failed.
