Tubular vesicopyelostomy for the management of types 2 and 3 (long-segment) ureteric stenosis after kidney transplantation
Late ureteral stenosis following kidney transplantation needs immediate correction in order to protect allograft function and requires a complicated surgical procedure. In this study, we present the long-term results of tubular bladder reconfiguration and cystopyelostomy (tubular vesicopyelostomy),...
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| Veröffentlicht in: | International journal of artificial organs 2019-01, Vol.42 (1), p.3-8 |
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| creator | Uslu, Adam Cayhan, Veli Kursat Simsek, Cenk Aykas, Ahmet Karatas, Murat Tarcan, Ismail Can Okut, Gokalp Tatar, Erhan |
| description | Late ureteral stenosis following kidney transplantation needs immediate correction in order to protect allograft function and requires a complicated surgical procedure. In this study, we present the long-term results of tubular bladder reconfiguration and cystopyelostomy (tubular vesicopyelostomy), an innovative and practical procedure for the management of long-segment ureteric stenosis (types 2 and 3) after transplantation. Between 2002 and 2017, 722 kidney transplant patients were monitored at the University of Medical Sciences, Bozyaka Organ Transplantation and Research Center. Twenty-eight of these patients underwent tubular vesicopyelostomy operation; 17 male and 11 female patients with a mean age of 45.6 ± 10.5 years. Time to surgical intervention for urinary tract obstruction was 122.5 ± 114.7 months. The mean serum creatinine values previous to and 3 days following the tubular vesicopyelostomy operation were 3.46 ± 1.5 mg/dL and 1.75 ± 0.7 mg/dL, respectively (p |
| doi_str_mv | 10.1177/0391398818796346 |
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In this study, we present the long-term results of tubular bladder reconfiguration and cystopyelostomy (tubular vesicopyelostomy), an innovative and practical procedure for the management of long-segment ureteric stenosis (types 2 and 3) after transplantation. Between 2002 and 2017, 722 kidney transplant patients were monitored at the University of Medical Sciences, Bozyaka Organ Transplantation and Research Center. Twenty-eight of these patients underwent tubular vesicopyelostomy operation; 17 male and 11 female patients with a mean age of 45.6 ± 10.5 years. Time to surgical intervention for urinary tract obstruction was 122.5 ± 114.7 months. The mean serum creatinine values previous to and 3 days following the tubular vesicopyelostomy operation were 3.46 ± 1.5 mg/dL and 1.75 ± 0.7 mg/dL, respectively (p < 0.0001). Within a mean follow-up period of 55.1 ± 40.9 months, functional grafts were recorded in 22 patients with a mean serum creatinine value of 1.92 ± 0.8 mg/dL. Only one patient developed anastomotic stenosis after the tubular vesicopyelostomy procedure, giving an overall success rate for tubular vesicopyelostomy of 96.4%. Six patients returned to hemodialysis. In five, the underlying etiology was not related to recurrent obstruction or surgical complications. Sixteen patients underwent allograft biopsy after the operation, but features of tubulointerstitial nephritis were seen in only one. Tubular vesicopyelostomy operation is a safe and successful method for the surgical treatment of late and complicated ureteral obstructions with excellent long-term results. It may be a good, practical alternative to other more sophisticated surgical options.</description><identifier>ISSN: 0391-3988</identifier><identifier>EISSN: 1724-6040</identifier><identifier>DOI: 10.1177/0391398818796346</identifier><identifier>PMID: 30182796</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Adult ; Anastomosis, Surgical - methods ; Biopsy ; Bladder ; Complications ; Creatinine ; Creatinine - analysis ; Dialysis ; Etiology ; Female ; Graft Survival ; Grafts ; Hemodialysis ; Humans ; Kidney Function Tests - methods ; Kidney transplantation ; Kidney Transplantation - adverse effects ; Kidneys ; Male ; Medical research ; Middle Aged ; Nephritis ; Obstructions ; Outcome Assessment (Health Care) ; Patients ; Postoperative Complications - diagnosis ; Postoperative Complications - etiology ; Postoperative Complications - surgery ; Reconfiguration ; Reconstructive Surgical Procedures ; Retrospective Studies ; Stenosis ; Surgery ; Transplantation ; Transplants & implants ; Turkey ; Ureter ; Ureteral Obstruction - diagnosis ; Ureteral Obstruction - etiology ; Ureteral Obstruction - surgery ; Urinary Bladder - surgery ; Urinary tract</subject><ispartof>International journal of artificial organs, 2019-01, Vol.42 (1), p.3-8</ispartof><rights>The Author(s) 2018</rights><rights>Copyright Wichtig Editore s.r.l. 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In this study, we present the long-term results of tubular bladder reconfiguration and cystopyelostomy (tubular vesicopyelostomy), an innovative and practical procedure for the management of long-segment ureteric stenosis (types 2 and 3) after transplantation. Between 2002 and 2017, 722 kidney transplant patients were monitored at the University of Medical Sciences, Bozyaka Organ Transplantation and Research Center. Twenty-eight of these patients underwent tubular vesicopyelostomy operation; 17 male and 11 female patients with a mean age of 45.6 ± 10.5 years. Time to surgical intervention for urinary tract obstruction was 122.5 ± 114.7 months. The mean serum creatinine values previous to and 3 days following the tubular vesicopyelostomy operation were 3.46 ± 1.5 mg/dL and 1.75 ± 0.7 mg/dL, respectively (p < 0.0001). Within a mean follow-up period of 55.1 ± 40.9 months, functional grafts were recorded in 22 patients with a mean serum creatinine value of 1.92 ± 0.8 mg/dL. Only one patient developed anastomotic stenosis after the tubular vesicopyelostomy procedure, giving an overall success rate for tubular vesicopyelostomy of 96.4%. Six patients returned to hemodialysis. In five, the underlying etiology was not related to recurrent obstruction or surgical complications. Sixteen patients underwent allograft biopsy after the operation, but features of tubulointerstitial nephritis were seen in only one. Tubular vesicopyelostomy operation is a safe and successful method for the surgical treatment of late and complicated ureteral obstructions with excellent long-term results. 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In this study, we present the long-term results of tubular bladder reconfiguration and cystopyelostomy (tubular vesicopyelostomy), an innovative and practical procedure for the management of long-segment ureteric stenosis (types 2 and 3) after transplantation. Between 2002 and 2017, 722 kidney transplant patients were monitored at the University of Medical Sciences, Bozyaka Organ Transplantation and Research Center. Twenty-eight of these patients underwent tubular vesicopyelostomy operation; 17 male and 11 female patients with a mean age of 45.6 ± 10.5 years. Time to surgical intervention for urinary tract obstruction was 122.5 ± 114.7 months. The mean serum creatinine values previous to and 3 days following the tubular vesicopyelostomy operation were 3.46 ± 1.5 mg/dL and 1.75 ± 0.7 mg/dL, respectively (p < 0.0001). Within a mean follow-up period of 55.1 ± 40.9 months, functional grafts were recorded in 22 patients with a mean serum creatinine value of 1.92 ± 0.8 mg/dL. Only one patient developed anastomotic stenosis after the tubular vesicopyelostomy procedure, giving an overall success rate for tubular vesicopyelostomy of 96.4%. Six patients returned to hemodialysis. In five, the underlying etiology was not related to recurrent obstruction or surgical complications. Sixteen patients underwent allograft biopsy after the operation, but features of tubulointerstitial nephritis were seen in only one. Tubular vesicopyelostomy operation is a safe and successful method for the surgical treatment of late and complicated ureteral obstructions with excellent long-term results. It may be a good, practical alternative to other more sophisticated surgical options.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>30182796</pmid><doi>10.1177/0391398818796346</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Anastomosis, Surgical - methods Biopsy Bladder Complications Creatinine Creatinine - analysis Dialysis Etiology Female Graft Survival Grafts Hemodialysis Humans Kidney Function Tests - methods Kidney transplantation Kidney Transplantation - adverse effects Kidneys Male Medical research Middle Aged Nephritis Obstructions Outcome Assessment (Health Care) Patients Postoperative Complications - diagnosis Postoperative Complications - etiology Postoperative Complications - surgery Reconfiguration Reconstructive Surgical Procedures Retrospective Studies Stenosis Surgery Transplantation Transplants & implants Turkey Ureter Ureteral Obstruction - diagnosis Ureteral Obstruction - etiology Ureteral Obstruction - surgery Urinary Bladder - surgery Urinary tract |
| title | Tubular vesicopyelostomy for the management of types 2 and 3 (long-segment) ureteric stenosis after kidney transplantation |
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