생체신이식에서 요로재건술에 따른 요로계 합병증의 차이

Abstract

Urologic complications that occurred in 21 patients of 270 recipients who underwent living donor renal transplantation during past 10 consecutive years since we started our renal transplantation program were reviewed. The first 88 patients were performed modified Politano technique for ureteral reconstruction(group 1) and from them, we experienced 9 cases of urologic complications including 2 ureteral obstruction, 1 vesicoureteral reflux, 1 spontancous graft rupture and 5 intractable gross hematuria. In the following 182 patients who received extravesical ureteroneocystostomy(group 2), we encountered 3 cases of urinary leakage from ureteroneocystostomy site and 1 case from anterior vesical wall where suprapubic ureterocystomy was done for stenting the re-implantation site. Unskilled technique to the new procedure seemed to be the major cause of these anastomotic site leakage. Vesicoureteric reflux, spontaneous graft kidney rupture and intractable gross bematuria were also seen in three patients but no ureteric obstruction except transient hydroureter. The frequency and type of complications seen in this article is not sufficient to evaluate the result of both types of ureteral reconstruction technique but the simplicity of extravesical ureteroneocystostomy and less incidence of intractable gross hematuria pushed us extravesical amastomosis as a preferred method.