A case of allograft ureteral stone successfully treated with antegrade ureteroscopic lithotripsy: use of a 3D-printed model to determine the ideal approach
A case of allograft ureteral stone successfully treated with antegrade ureteroscopic lithotripsy: use of a 3D-printed model to determine the ideal approach
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DOI：
10.1007/s00240-019-01153-x
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发表时间：
2019-10-01
期刊：
影响因子：
3.1
通讯作者：
Uemura, Hiroji
中科院分区：
文献类型：
--
作者：
Kuroda, Shinnosuke;Kawahara, Takashi;Uemura, Hiroji
我们报告一位46岁的男性患者，因异体输尿管结石而接受顺行输尿管镜手术。在移植后15年的计划随访中，计算机断层扫描（CT）在移植肾的肾盂中检测到12 mm的肾结石。在他的随访中，肉眼血尿;结石移动到输尿管，导致肾积水。超音波及非造影电脑断层显示肾积水及一个15毫米的结石在移植的输尿管。考虑到结石的大小、位置和进入闭合的输尿管口的难度，计划经皮输尿管镜入路。由于他的同种异体肾的解剖学困难，我们计划准备一个3D图像和模型，以选择最佳的经皮入路。进行了手术，获得了无结石状态，无并发症。在精确的模拟下，我们在3D成像的支持下成功地对同种异体输尿管结石进行了顺行输尿管镜检查。使用3D打印模型可以帮助安全有效地治疗同种异体肾和输尿管结石。
We present the case of a 46-year-old man who underwent successful antegrade ureteroscopy for lithiasis in his allograft ureter. At a scheduled follow-up 15 years after transplantation, computed tomography (CT) detected a 12-mm renal stone in the renal pelvis of the transplanted kidney. During his follow-up, gross hematuria was seen; the stone moved to the ureter, causing hydronephrosis. Ultrasound and non-contrast CT revealed hydronephrosis and a 15-mm stone in the transplanted ureter. Considering the stone size, location, and the difficulty of the access to the anastomosed ureteral orifice, percutaneous ureteroscopic approach was planned. Due to the anatomical difficulty regarding his allograft kidney, we planned to prepare a 3D image and model for selecting the best percutaneous approach. The procedure was performed and a stone-free status was acquired without complication. Under precise simulation, we performed successful antegrade ureteroscopy for lithiasis in the allograft ureter supported by 3D imaging. Use of a 3D printed model may aid in a safe and effective procedure for lithiasis in the allograft kidney and ureter.