自体肾盂输尿管在肾移植术中的应用  

Application of native pelvis and ureter in kidney transplantation

作　　者：董隽[1] 洪宝发[1] 杨勇[1] 叶林阳[1] 肖序仁[1] 高江平[1] 敖建华[1] 王晓雄[1] 李炎唐[1] 

机构地区：[1]解放军总医院泌尿外科,北京100853

出　　处：《中华器官移植杂志》2003年第4期246-247,共2页Chinese Journal of Organ Transplantation

摘　　要：目的　报告自体肾盂输尿管在肾移植术中的应用。方法　应用自体肾盂输尿管治疗各种移植肾输尿管并发症 18例 ,男 13例 ,女 5例 ,年龄 2 8～ 5 6岁 ,平均 4 2岁。 10例尿瘘患者 ,3例行自体输尿管与移植肾盂成形术 ,2例行自体输尿管与移植肾输尿管吻合术 ,5例行自体肾盂移植、肾盂成形术 ;5例移植肾输尿管过短术中均行自体输尿管与移植肾输尿管吻合术 ;3例移植肾输尿管狭窄均行自体输尿管与移植肾输尿管吻合术。结果　术后随访 3个月～ 8年 ,2例因慢性排斥反应 ,移植肾失功 ,余 16例移植肾功能正常。结论　自体肾盂输尿管是治疗某些肾移植后输尿管并发症的一种有效方法。Objective To study the application of native pelvis and ureter in kidney transplantation. Methods Between 1977 and 2001, 1 364 kidney transplantations were performed in our institution. 18 cases of ureteral complication after kidney transplantation were treated with native pelvis and ureter. The mean age of the patients was 42 years. In 10 patients with urine leakage, 3 cases underwent pyeloureterostomy using native ureter, 2 cases ureteroureterostomy using native ureter and 5 cases pyelopyelostomy using native pelvis. Five cases due to short ureter underwent ureteroureterostomy using native ureter. Three cases of ureteral stenosis were subjected to ureteroureterostomy using native ureter.Results Two grafts were rejected. Sixteen patients developed a normal function of kidney postoperatively (follow up: 3 months to 8 years). Conclusion Application of native pelvis and ureter might be a therapy of choice when secondary reconstruction by re-ureteroneocystostomy is not possible.

关 键 词：肾移植术 自体肾盂输尿管 手术并发症 尿瘘 输尿管过短 输尿管狭窄 

分 类 号：R699.2[医药卫生—泌尿科学]