关键词: 肾移植, 尿瘘, 大网膜, 输尿管膀胱吻合, 分类

Abstract:

The etiological factor, diagnosis, as well as therapeutic results of 23 cases with urinary fistula following renal transplantation, at the Chengdu Military General Hospital, from December 1998 to December 2008, were analyzed retrospectively, including 21 cases with a renal transplantation, 2 cases with retransplantation; 9 cases adopt renal artery, renal veins to external iliac artery, external iliac vein anastomosis, 14 cases with renal artery to internal iliac artery, renal veins to external iliac vein anastomosis. 23 cases were followed-up for 6-12 months, 17 cases suffered urinary fistula at days 3-7 after transplantation, 6 cases occurred at days 7-10; there were 17 stoma fistulae, 4 distal end necrosis of ureter, 2 ureteral fistulae. 11 cases were received conservative treatment, and 12 cases with operation. Among the surgery patients, 9 cases received conventional operation and 1 of them returned with urinary fistula and then was cured by second operations; 3 patients received pedicled omentum transplantation and no recurrence or hydronephrosis happened with normal renal function. The one-time success rate was 92% (11/12), of which the repair success rate using pedicled omental was 100%. The results demonstrated that prevention plays an important role in urinary fistula, and ureter should be protected during the surgery. Meanwhile, stoma fistula should be avoided. Promptly treatment following urinary fistula is also necessary to reduce the damage of urinary fistula to the renal function.