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Kidney transplant ureteroneocystostomy: comparison of full‐thickness vs. L ich– G regoir techniques
Author(s) -
Kayler Liise,
Zendejas Ivan,
Molmenti Ernesto,
Chordia Poorvi,
Schain Denise,
Magliocca Joseph
Publication year - 2012
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/j.1399-0012.2012.01655.x
Subject(s) - medicine , urinary system , urology , renal function , kidney transplantation , transplantation , urine , kidney , surgery , incidence (geometry) , hematoma , upper urinary tract , ureter , physics , optics
Despite a variety of urinary tract reconstructive techniques, urinary complications are the most frequent technical adverse event following kidney transplantation. We examined outcomes of two ureteroneocystostomy techniques, the full‐thickness ( FT ) technique and the L ich– G regoir ( LG ) technique in 634 consecutive kidney‐alone transplants (327 FT and 307 LG ) between D ecember 2006 and D ecember 2010. Urological complications at one yr post‐transplantation occurred in 27 cases (4.3%) including 16 ureteral strictures (2.5%), four ureteral obstructions (0.6%) owing to donor‐derived stones or intrinsic hematoma, and seven urine leaks (1.1%). Compared with LG , the FT technique was associated with similar proportions of ureteral complications overall (3.9% vs. 4.6%, p = 0.70), ureteral strictures (3.7% vs. 1.3%, p = 0.08), urinary stones/hematoma (1.0% vs. 0.3%, p = 0.36), and overall urinary leaks (1.6% vs. 0.6%, p = 0.22); however, the FT technique was associated with somewhat fewer urine leaks at the ureterovesical junction (0% vs. 1.3%, p = 0.05). There were no differences between the two groups in terms of length of stay, delayed graft function, urinary tract infection with the first post‐transplant year, estimated glomerular filtration rate, and overall graft and patient survival. The FT technique of ureteroneocystostomy is technically simple to perform and has a similar incidence of urinary complications compared with the LG technique.