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目的:探讨肾移植术中供肾输尿管异常的手术处理方法。方法:回顾性分析18例供肾输尿管异常的肾移植术中处理,包括损伤致输尿管过短8例,完全型双输尿管4例,不完全型双输尿管2例,输尿管结石2例,巨输尿管2例。根据具体情况采用输尿管膀胱吻合术、供受者输尿管端端吻合术和膀胱腰大肌悬吊术等方法再植输尿管。结果:术后恢复顺利,未发生移植肾功能延迟恢复和尿漏。随访3～8年,发生输尿管梗阻1例,行经皮肾造口输尿管镜切开后治愈。发生尿路感染5例(其中2例为反复感染)。未见膀胱输尿管返流。结扎输尿管的原肾未出现胀痛和不适,B超检查未见肾积水。带输尿管结石移植肾未见结石复发。巨输尿管供肾移植后输尿管管径稳定,无明显增大。结论:供肾输尿管损伤和异常时采用不同的技术修复和再植输尿管,可减少并发症的发生。
Objective: To investigate the surgical treatment of kidney ureter abnormalities during kidney transplantation. Methods: A retrospective analysis of 18 cases of kidney transplantation for renal dysplasia, including 8 cases of ureteral injury caused by short, 4 cases of complete double ureter, 2 cases of incomplete ureter, ureteral calculi in 2 cases, giant ureter 2 example. According to the specific circumstances of ureterovascular anastomosis, donor ureteral anastomosis and bladder psoas suspension and other methods replant ureter. Results: The postoperative recovery was successful. There was no delayed recovery of graft function and urine leakage. Followed up for 3 to 8 years, ureteral obstruction occurred in 1 case, percutaneous nephrostomy ureteroscopic cure. Urinary tract infection occurred in 5 cases (2 cases of repeated infections). No vesicoureteral reflux. Ligation of the ureter of the original kidney did not appear pain and discomfort, B-ultrasound showed no hydronephrosis. Ureteral calculi with no recurrence of stones. Giant ureter for renal transplanting ureter diameter stability, no significant increase. Conclusion: There are different techniques to repair and replant the ureter during the ureter injury and abnormalities, which can reduce the incidence of complications.