PROBLEMS OF THE DISTAL URETER IN RENAL-TRANSPLANTATION
PROBLEMS OF THE DISTAL URETER IN RENAL-TRANSPLANTATION
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DOI：
10.1159/000282399
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发表时间：
1992-01-01
影响因子：
1.6
通讯作者：
DREIKORN, K
中科院分区：
文献类型：
--
作者：
DREIKORN, K
近十年来，肾移植术后泌尿系统并发症的发生率和死亡率显著下降。这是通过改进技术的供体肾切除术与保留输尿管血液供应和完善的程序重建尿路。膀胱内和膀胱外输尿管膀胱吻合术已被证明是最可靠和首选的技术，以恢复尿路连续性。除了输尿管缺血和技术失败外，输尿管排斥反应越来越被认为是输尿管瘘和狭窄形成的重要原因。关于反流进入移植物的发病机制及其对移植物长期功能的影响仍然存在争议。经皮和内窥镜手术已补充并部分取代开放手术治疗输尿管瘘和狭窄。通过遵循上述原则，可以将泌尿系统并发症的发生率及其相关死亡率降至最低。
The incidence and mortality rates of urologic complications in renal transplantation have decreased significantly during the last decade. This was achieved by improved techniques of donor nephrectomy with preservation of the ureteric blood supply and refined procedures for the reconstruction of the urinary tract. Intra- and extravesical ureteroneocystostomies have shown to be the most reliable and preferred techniques to restore the urinary tract continuity. Beside ureteral ischemia and technical failure ureteral rejection is increasingly accepted as an important contributory factor for the development of ureteric fistula and stenosis formation. Controversy still exists concerning the pathogenesis of reflux into the graft and its impact on long-term graft function. Percutaneous and endoscopic procedures have supplemented and partially replaced open surgical management of ureteric fistulas and stenoses. By adherence to the principles described the frequency of urologic complications and its associated mortality rates can be minimized.