空军军医大学学报2025，Vol.46Issue(9)：1143-1147,5.DOI:10.13276/j.issn.2097-1656.2025.09.004
经尿道移植肾输尿管支架管置入术治疗移植肾输尿管狭窄经验探讨
Experience in the treatment of ureteral stricture in transplant kidney by transurethral ureteral stent placement
摘要
Abstract
Objective To explore the techniques of transurethral ureteral stent placement for renal transplant recipients and improve the success rate of the procedure.Methods The clinical data of 45 patients who underwent transurethral ureteral stent placement for hydronephrosis with ureteral stricture after kidney transplantation from December 2023 to December 2024 were collected.The success rate of stent placement was observed,the causes of hydronephrosis were summarized,and the intraoperative difficulties and solutions were analyzed to improve the success rate of stent placement.Results Among the 45 patients,33(73.33％)successfully underwent retrograde ureteral catheterization via ureteroscopy,while 12(26.67％)failed.Among the unsuccessful cases,4(8.89％)underwent nephrostomy,and 8(17.78％)underwent open ureteral reimplantation surgery.The 33 patients with successful catheterization all recovered well,with significant relief of hydronephrosis and a marked decrease in serum creatinine levels one week after surgery[(216.81±107.07)μmol/L vs(163.72±56.04)μmol/L,P=0.001].No severe surgical complications occurred during the catheterization process in either group of patients.Common complications included hematuria,urinary tract infections,and discomfort in the transplanted kidney area.After a 3-month learning period,the success rate of catheterization improved significantly from 50.00％(7/14)to 83.87％(26/31),with a significant statistical difference(P=0.017).No severe adverse reactions occurred in any patient during the perioperative period.Conclusion Transurethral ureteral stent placement has shown excellent clinical outcomes in treating renal dysfunction caused by ureteral stricture in kidney transplant recipients.This procedure is minimally invasive with few surgical complications.The success rate of stent placement can be significantly improved with accumulated experience.Early stent placement can effectively alleviate acute renal obstruction,but the underlying causes such as ureteral stricture and tortuosity in the transplanted kidney still require further treatment.关键词
肾移植/输尿管梗阻/支架/输尿管镜检查/肾积水/治疗结果/再次手术/术后并发症Key words
kidney transplantation/ureteral obstruction/stents/ureteroscopy/hydronephrosis/treatment outcome/reoperation/postoperative complications分类
医药卫生引用本文复制引用
阮东丽,杨文辉,王会龙,黄怡,陈波朋,师帅,贺晨晖,李智斌..经尿道移植肾输尿管支架管置入术治疗移植肾输尿管狭窄经验探讨[J].空军军医大学学报,2025,46(9):1143-1147,5.基金项目
陕西省重点研发计划项目(2024SF-YBM-195) （2024SF-YBM-195）
