Zerrin BİCİK, Şevki SERT, Ülver DERİCİ, Aydın DALGIÇ, Turgay ARINSOY, Şükrü SİNDEL

Renal transplantasyon ve üreter nekrozu

Üreter nekrozu sıklıkla uretero neosistostomi bölgesinde cerrahi tekniklere bağlı olarak gelişen erken postoperatif komplikasyondur. İdrar kaçağının erken tanı ve cerrahi tedavisinin greft hasta morbidite ve mortalitesini düşürdüğü bilinmektedir. Bu yazıda; erken ureteral nekroz ve idrar kaçağı tespit edilen 3 renal transplantlı hasta rapor edilmiştir. Bu 3 olgu ile üriner kaçakların erken tanı ve tedavisinin greft fonksiyonunu koruma ve hasta mortalite ve morbiditesini önlemedeki önemi vurgulanmıştır.

Anahtar Kelimeler:

Böbrek nakli, Üreter hastalıkları, Ameliyat sonrası komplikasyonlar, Nekroz, Ölüm oranı, Hastalık oranı

Renal transplantation and ureteral necrosis

Urinary leak is an early postoperative problem, often resulting from technical errors at the site of ureteroneocystostomy. It is well known that early detection and early surgical repair of urinary leak reduces graft and patient morbidity and mortality. We've reported 3 cases who are renal transplant recipients with ureteral necrosis and urinary leaks. With these cases; we purposed to point out early detection and immediate repairment of urinary leaks save the graft functions and patient morbidity and mortality.

Keywords:

Kidney Transplantation, Ureteral Diseases, Postoperative Complications, Necrosis, Mortality, Morbidity,

PDF

___

1.Kashi SH, Lodge JP, Gıles GR, irvıng HC:Ureteric Complications of Renal Transplantation.Br J Urol 1992;70:139-143.
2. Solomon L, Saporta F, Amsellem D et al. Results of Pyeloureterostomy after Ureterovesica! Anastomosis Complications in RenalTransplantation.Urology 1999;53 (5): 908-912
3. Colfry AJ Jr, Schlagel JU. Urological Complications in Renal Transplantation. J Urol. 1974;112: 564-566,
4. Laughlin KR: Tilney NL, Richie JD. Urological Complications in 718 Renal Transplant Patients. Br J Urol 1981; 53: 397-402,
5. Odland M D, Surgical Technique in Posttransplant Surgical Complications. Surg Clin N Am 1998;78(1):55-60
6. Bennet AH, Urologic Complications of Renal Transplantation. Cerilli TG, ed, Organ Transplantation and Replacement, WB,Lippincot Comp. Philladeiphia,1988: Chap:28,pp:433-437
7. Sert Ş, Gülay H, Hamaloğlu E, Haberal M, Urological Complication in 350 Consecutive Rena! Transplants, Br j Urol. ,1981; 53: 397-402
8. HW.Sollinger, EM.Messing,DE. Eckhofî et al. Urological Complications in 210 Consecutive Simultaneous Pancreas-KidneyTransplants with Bladder Drainage. Ann Surgery 1998; 218( 4): 561-570
9. Arthur I. Sagalovvsky, Urologic Complications in Renal Transplanîation. Davidson Ingemar JA, ed. Kidnev and PancreasTransplantation. ed. Landes Bıoscıence .Austin,Texas,1998: 189-203
10. Kitapçı MT. Renal Transplant değerlendirmesinde Radyonüklid Yöntemler, Türk Nefroloji Diyaliz Transplantasyon Dergisi, 2000;1:8-13
11. Kitapçı MT. Renai Transplantasyon sonrası gelişen Üreter Nekrozunun Erken Tanısında Renal Sintigrafinin Önemi, Türk NefrolojiDiyaliz Transplantasyon Dergisi, 2000; 1: 58-59
12. Hans O. Leven, Elijah O. Kehinde, Percutaneous Management of a Chronic Post-transplant Üreteral Leak. Scand J Uroi Nephroi,1997:31,99-101
13. F.Desgrandcharnps.P. Paulhac. S. Fornaıron et al., Artificial Üreteral Replacement for Üreteral Necrosis After renal Transpiantatîon:report of 3 Cases, J Urol 1998; 159:1830-1832
14. J. Thomas Rosenthal, The Transplant Operation and Its Surgica! Complications. Gabriel M. Danovitch, ed. Handbook of KidnevTransplantation. 2. ed. Little Brown Comp. Boston 1996, 123-137*