Urological complications in 980 consecutive patients with renal transplantation

Aim: To present the urological complications of renal transplantations performed in the last 14 years at one center and to briefly explain a modified method of Lich–Gregoir ureteroneocystostomy. Methods: The data of 980 patients receiving kidney transplants at the authors' institution from Apri...

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Veröffentlicht in:International journal of urology 2006-10, Vol.13 (10), p.1271-1275
Hauptverfasser: DAVARI, HAMID R, YARMOHAMMADI, HOOMAN, MALEKHOSSEINI, SEYED A, SALAHI, HESHMATOLLAH, BAHADOR, ALI, SALEHIPOUR, MEHDI
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container_end_page 1275
container_issue 10
container_start_page 1271
container_title International journal of urology
container_volume 13
creator DAVARI, HAMID R
YARMOHAMMADI, HOOMAN
MALEKHOSSEINI, SEYED A
SALAHI, HESHMATOLLAH
BAHADOR, ALI
SALEHIPOUR, MEHDI
description Aim: To present the urological complications of renal transplantations performed in the last 14 years at one center and to briefly explain a modified method of Lich–Gregoir ureteroneocystostomy. Methods: The data of 980 patients receiving kidney transplants at the authors' institution from April 1991 to February 2004 were reviewed in a retrospective prospective study. In particular, surgical techniques and urological complications were noted. Results: A total of 980 patients had received kidney transplantation. Extravesical ureteroneocystostomy (Lich–Gregoir method) was used in the first 480 patients (group A). In the subsequent 500 patients, the authors' modified method of extravesical ureteroneocystostomy, using single layer anastomosis and small feeding tubes as stent, was used (group B). Overall urological complication rate was 2.8% (28 patients), including leakage (13 patients, 1.3%), stenosis (seven, 0.7%), obstruction (one, 0.1%), distal ureter necrosis (four, 0.4%), pelvocalyceal fistula (two, 0.2%) and implantation of ureter into the peritoneum (one, 0.1%). Urological complications were significantly more common in group A compared to group B (16, 3.3% and 9, 1.8%, respectively; P 
doi_str_mv 10.1111/j.1442-2042.2006.01539.x
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Methods: The data of 980 patients receiving kidney transplants at the authors' institution from April 1991 to February 2004 were reviewed in a retrospective prospective study. In particular, surgical techniques and urological complications were noted. Results: A total of 980 patients had received kidney transplantation. Extravesical ureteroneocystostomy (Lich–Gregoir method) was used in the first 480 patients (group A). In the subsequent 500 patients, the authors' modified method of extravesical ureteroneocystostomy, using single layer anastomosis and small feeding tubes as stent, was used (group B). Overall urological complication rate was 2.8% (28 patients), including leakage (13 patients, 1.3%), stenosis (seven, 0.7%), obstruction (one, 0.1%), distal ureter necrosis (four, 0.4%), pelvocalyceal fistula (two, 0.2%) and implantation of ureter into the peritoneum (one, 0.1%). Urological complications were significantly more common in group A compared to group B (16, 3.3% and 9, 1.8%, respectively; P &lt; 0.05). Conclusions: Preserving the adventitia, fat and blood supply of the ureter by delicate dissection of the ureter during donor nephrectomy, short ureters, and fixation of the adventitia, fat and blood supply of the ureter to the bladder wall, to prevent kinking or twisting, are important factors in decreasing urological complications. 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Methods: The data of 980 patients receiving kidney transplants at the authors' institution from April 1991 to February 2004 were reviewed in a retrospective prospective study. In particular, surgical techniques and urological complications were noted. Results: A total of 980 patients had received kidney transplantation. Extravesical ureteroneocystostomy (Lich–Gregoir method) was used in the first 480 patients (group A). In the subsequent 500 patients, the authors' modified method of extravesical ureteroneocystostomy, using single layer anastomosis and small feeding tubes as stent, was used (group B). Overall urological complication rate was 2.8% (28 patients), including leakage (13 patients, 1.3%), stenosis (seven, 0.7%), obstruction (one, 0.1%), distal ureter necrosis (four, 0.4%), pelvocalyceal fistula (two, 0.2%) and implantation of ureter into the peritoneum (one, 0.1%). Urological complications were significantly more common in group A compared to group B (16, 3.3% and 9, 1.8%, respectively; P &lt; 0.05). Conclusions: Preserving the adventitia, fat and blood supply of the ureter by delicate dissection of the ureter during donor nephrectomy, short ureters, and fixation of the adventitia, fat and blood supply of the ureter to the bladder wall, to prevent kinking or twisting, are important factors in decreasing urological complications. Additionally, the authors' method of ureteroneocystostomy is also effective in decreasing the incidence of ureteric complications.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Cystostomy - methods</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Incidence</subject><subject>kidney transplant</subject><subject>Kidney Transplantation - adverse effects</subject><subject>Lich-Gregoir</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Postoperative Complications</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Retrospective Studies</subject><subject>Ureteral Diseases - epidemiology</subject><subject>Ureteral Diseases - etiology</subject><subject>Ureteral Diseases - surgery</subject><subject>ureteroneocystostomy</subject><subject>Ureterostomy - methods</subject><subject>urological complications</subject><issn>0919-8172</issn><issn>1442-2042</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkMtOwzAQRS0EgvL4BZQVu4TxI7GzYAEICgjxkKhgZyVmAi5pEuwUyt_j0Aq2eOOR557x6BASUUhoOIfThArBYgaCJQwgS4CmPE8Wa2T021gnI8hpHisq2RbZ9n4KQDmjapNsUQkUAPiI3E5cW7cv1hR1ZNpZV4eqt23jI9tEuYLw2Hg0895-YNSFFja9jz5t_xo5bALUu6LxXV00_Q-3Szaqova4t7p3yOT87OH0Ir6-HV-eHl_HRqQqj2klK5OiSMNyVQbPRhrOeK4kZ6UAagBTJoUqizLlytASpZJYIlYQaKaQ75CD5dzOte9z9L2eWW-wDotgO_c6UzllArIQVMugca33DivdOTsr3JemoAeZeqoHZ3pwpgeZ-kemXgR0f_XHvJzh8x-4shcCR8vAp63x69-D9eXVZKgCHy9563tc_PKFe9OZ5DLVjzdjfQ-PT-L-7kQz_g0o_5Iu</recordid><startdate>200610</startdate><enddate>200610</enddate><creator>DAVARI, HAMID R</creator><creator>YARMOHAMMADI, HOOMAN</creator><creator>MALEKHOSSEINI, SEYED A</creator><creator>SALAHI, HESHMATOLLAH</creator><creator>BAHADOR, ALI</creator><creator>SALEHIPOUR, MEHDI</creator><general>Blackwell Publishing Asia</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200610</creationdate><title>Urological complications in 980 consecutive patients with renal transplantation</title><author>DAVARI, HAMID R ; YARMOHAMMADI, HOOMAN ; MALEKHOSSEINI, SEYED A ; SALAHI, HESHMATOLLAH ; BAHADOR, ALI ; SALEHIPOUR, MEHDI</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4589-1f7fc5e45172f60dc7c32398732b401c0e52748bab538c1be787ebeef058928e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Cystostomy - methods</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Incidence</topic><topic>kidney transplant</topic><topic>Kidney Transplantation - adverse effects</topic><topic>Lich-Gregoir</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Postoperative Complications</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Retrospective Studies</topic><topic>Ureteral Diseases - epidemiology</topic><topic>Ureteral Diseases - etiology</topic><topic>Ureteral Diseases - surgery</topic><topic>ureteroneocystostomy</topic><topic>Ureterostomy - methods</topic><topic>urological complications</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>DAVARI, HAMID R</creatorcontrib><creatorcontrib>YARMOHAMMADI, HOOMAN</creatorcontrib><creatorcontrib>MALEKHOSSEINI, SEYED A</creatorcontrib><creatorcontrib>SALAHI, HESHMATOLLAH</creatorcontrib><creatorcontrib>BAHADOR, ALI</creatorcontrib><creatorcontrib>SALEHIPOUR, MEHDI</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of urology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>DAVARI, HAMID R</au><au>YARMOHAMMADI, HOOMAN</au><au>MALEKHOSSEINI, SEYED A</au><au>SALAHI, HESHMATOLLAH</au><au>BAHADOR, ALI</au><au>SALEHIPOUR, MEHDI</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Urological complications in 980 consecutive patients with renal transplantation</atitle><jtitle>International journal of urology</jtitle><addtitle>Int J Urol</addtitle><date>2006-10</date><risdate>2006</risdate><volume>13</volume><issue>10</issue><spage>1271</spage><epage>1275</epage><pages>1271-1275</pages><issn>0919-8172</issn><eissn>1442-2042</eissn><abstract>Aim: To present the urological complications of renal transplantations performed in the last 14 years at one center and to briefly explain a modified method of Lich–Gregoir ureteroneocystostomy. Methods: The data of 980 patients receiving kidney transplants at the authors' institution from April 1991 to February 2004 were reviewed in a retrospective prospective study. In particular, surgical techniques and urological complications were noted. Results: A total of 980 patients had received kidney transplantation. Extravesical ureteroneocystostomy (Lich–Gregoir method) was used in the first 480 patients (group A). In the subsequent 500 patients, the authors' modified method of extravesical ureteroneocystostomy, using single layer anastomosis and small feeding tubes as stent, was used (group B). Overall urological complication rate was 2.8% (28 patients), including leakage (13 patients, 1.3%), stenosis (seven, 0.7%), obstruction (one, 0.1%), distal ureter necrosis (four, 0.4%), pelvocalyceal fistula (two, 0.2%) and implantation of ureter into the peritoneum (one, 0.1%). Urological complications were significantly more common in group A compared to group B (16, 3.3% and 9, 1.8%, respectively; P &lt; 0.05). Conclusions: Preserving the adventitia, fat and blood supply of the ureter by delicate dissection of the ureter during donor nephrectomy, short ureters, and fixation of the adventitia, fat and blood supply of the ureter to the bladder wall, to prevent kinking or twisting, are important factors in decreasing urological complications. Additionally, the authors' method of ureteroneocystostomy is also effective in decreasing the incidence of ureteric complications.</abstract><cop>Melbourne, Australia</cop><pub>Blackwell Publishing Asia</pub><pmid>17010003</pmid><doi>10.1111/j.1442-2042.2006.01539.x</doi><tpages>5</tpages></addata></record>
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subjects Adolescent
Adult
Child
Child, Preschool
Cystostomy - methods
Female
Follow-Up Studies
Humans
Incidence
kidney transplant
Kidney Transplantation - adverse effects
Lich-Gregoir
Male
Middle Aged
Postoperative Complications
Prognosis
Prospective Studies
Retrospective Studies
Ureteral Diseases - epidemiology
Ureteral Diseases - etiology
Ureteral Diseases - surgery
ureteroneocystostomy
Ureterostomy - methods
urological complications
title Urological complications in 980 consecutive patients with renal transplantation
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