Ureteral reimplantation after deflux failure for vesicoureteral reflux in renal transplant
| Autor: | Bastien Gondran-Tellier, Eric Lechevallier, M. Morelli, Gilles Karsenty, Romain Boissier, Emanuele Montanari, Michael Baboudjian, A. Akiki, Robin McManus, Abel Tadrist, Véronique Delaporte, Sergio Concetti |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Male
Nephrology medicine.medical_specialty Urology medicine.medical_treatment urologic and male genital diseases Vesicoureteral reflux Postoperative Complications Ureter Internal medicine medicine Humans Treatment Failure Retrospective Studies Vesico-Ureteral Reflux Kidney business.industry Retrospective cohort study Middle Aged medicine.disease Kidney Transplantation Nephrectomy Surgery Treatment Outcome medicine.anatomical_structure Renal transplant Replantation Urologic Surgical Procedures Female business Ureteral reimplantation |
| Zdroj: | World Journal of Urology. 40:271-276 |
| ISSN: | 1433-8726 0724-4983 |
| DOI: | 10.1007/s00345-021-03814-2 |
| Popis: | To evaluate the outcomes of ureteral reimplantation (UR) after failure of endoscopic treatment for symptomatic vesicoureteral reflux (VUR) in renal transplant recipients. We conducted a monocentric retrospective study that included all renal transplant recipients with failure of Deflux™ as first-line treatment of VUR from January 2007 to December 2020. Failure of Deflux™ was defined by: VUR on retrograde cystography and at least one acute pyelonephritis of the renal graft. The preferred surgical treatment was native ureteropyelostomy (NPUS) in the recent years. If the native ureter could not be used, ureteroneocystostomy (UNC) was performed. The primary outcome was the clinical efficacy of UR defined as the absence of acute graft pyelonephritis during follow-up. Out of 1565 kidney transplantations, 119 (7.6%) had symptomatic VUR treated with bulking agent. 35 (29.4%) had Deflux™ failure and were addressed to UR: 21/35 (60%) NPUS and 14/35 (40%) UNC. The median estimated blood loss, operative time, and length of stay were 120 mL, 90 min, and 7 days, respectively. After a median follow-up of 7.1 (IQR 4.1–9.8) years, UR was clinically successful in a total of 32 patients (91.4%): 20 (95.2%) and 12 (85.7%) patients in the NPUS and UNC groups, respectively (p = 0.55). Three (8.5%) high-grade complications have been reported. No nephrectomy of native kidney was required in the NPUS group. After failure of Deflux™ for VUR of renal graft, surgical treatment with native ureteropyelostomy or ureteroneocystostomy is associated to a high success rate and few high-grade complications. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink