ÜRETER DUBPLİKASYONLU GREFT BÖBREKLERDE NAKİL TECRÜBEMİZ

Yucel Yuksel

doi:10.17343/sdutfd.499151

ÜRETER DUBPLİKASYONLU GREFT BÖBREKLERDE NAKİL TECRÜBEMİZ

Abstract

ÜRETER DUPLİKASYONU OLAN GREFT BÖBREKLERDE BÖBREK NAKLİ TECRÜBEMİZ

Amaç: Kronik böbrek yetmezliğininin en etkili, tedavisi böbrek naklidir . Böbrek nakli sonrası ürolojik komplikasyonlar, morbiditeyi arttırmaktadır . Üreter duplikasyonu ( ÜD), üst üriner sistemin en sık görülen anomalisidir . ÜD prevalansı, % 0.6-% 1, arasında değişmektedir. ÜD’lu böbrek greftlerinde yapılacak üreter mesane anastomuzunun nasıl yapılacağı ilgili görüş birliği yoktur. Bu çalışmamızda, kliniğimizde yapılmış olan ÜD'lu renal transplantasyon tecrübelerimizi ve sonuçlarımızı paylaşmayı amaçladık.

Gereç ve Yöntem: Ocak 2013- Aralık 2017 tarihleri arasında Antalya Medicalpark Organ Nakli Bölümünde ÜD’li greft böbrek ile böbrek nakli yapılan hastaların sonuçları retrospektif olarak analiz edildi. Hastaların yaş, cinsiyet, donör türü, donör yaşı, donör ameliyatının tipi, böbrek nakli sonrası takip süresi, ortalama ameliyat süresi, böbrek nakliöncesi dializ türleri, böbrek nakli sayısı, böbrek nakli sonrası üriner komplikasyonlara, kreatinin düzeyi, greft sağ kalımı ile birlikte hasta sağ kalımına değerlendirildi.

Bulgular: Merkezimizde ocak 2013- aralık 2017 tarihleri arasında 2039 böbrek nakli yapıldı. Olguların 28 (% 0,1)’inde ÜD saptandı. Hastaların ortalama yaşı 38 .07 ±14.7 (range 8-60). Erkek kadın oranı 1.1 di. Böbrek alıcılarının 15’i erkek 13'ü kadındı, böbrek donörlerinin 22'si canlı 6'sı kadavraydı. Donörlerde (kadın, erkek )oranı 3 saptandı. Ortalama donör yaşı 48.6 ± 15.5 (14-81) di. 13 hasta preemptif, 14 hasta hemodializ, 1 hasta da periton dializi yapmakta idi. Ortalama ameliyat süresi 80.6±13.4 dakika (65-109). Bir hastada böbrek nakli sonrası 2. ayda idrar kaçağı oluştu (%3.5). Diğer hastalarda üriner komplikasyon saptanmadı.

Sonuç: Böbrek naklinde greft böbreklerde ÜD böbrek nakli için engel kabul edilmemelidir, tecrübelerimize göre ÜD olan greft böbreklerde tek ostiumlu Lich Gregoir Üreteroneosistostomi, yöntemi, 2 adet DJS kullanılarak yapılması, diğer yöntemlere göre daha güvenlidir.

Anahtar Kelimeler: Böbrek Transplantasyonu, Üreter dublikasyonu, Üreteroneosistostomi, Komplikasyon

OUR EXPERİNCE WİTH KİDNEY TRANSPLANTAİON IN KIDNEYS WİTH URETER DUPLİCATİON

Purpose: The most effective treatment of chronic renal failure is kidney transplantation. Urological complications after kidney transplantation increase morbidity. Ureter duplication (UD) is the most common anomaly of the upper urinary tract. . There is no consensus on how to perform ureter bladder anastomosis in kidney grafts with double ureters. In this study, we aimed to share our experience and results of renal transplantation with grafts having UD anomaly performed in our clinic.
Methods: Between January 2013 and December 2017, the results of transplantations at Antalya Medical Park Transplantation Center with kidney grafts which had ureteral duplication were analyzed retrospectively . Age, sex, donor type, age of donor, type of donor operation, duration of renal transplantation, mean operation time, pre-renal dialysis types, number of kidney transplants, urinary complications after kidney transplantation, creatinine level, graft surviv and patient survival were evaluated
Results: Between January 2013 and December 2017, 2039 kidney transplants were performed in our transplantation center. UD was detected in 28 cases (0.1%). The mean age of donors was 48.6 ± 15.5 (14-81). The mean operative time was 80.6 ± 13.4 minutes (65-109). Urinary leakage occurred in one patient (3.5%) within the 2 months after renal transplantation .There were no urinary complications in other patients
Conclusion:In renal transplantation, the graft with ureteral duplication should not be considered as an obstacle for renal transplantation .We experienced that Lich Gregoir Ureteroneocystostomy method with single-ostium by using 2 Double –J stents in the kidney grafts with UD is safer than other method.

Keywords: Kidney transplantion, Ureter duplication Ureteroneocystostomy, Complications

Keywords

Böbrek Transplantasyonu,Üreter Duplikasyonu,Üretereneosistostomi,Komplikasyon

References

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Details

Primary Language

Turkish

Subjects

Surgery

Journal Section

Research Article

Authors

Yucel Yuksel ^*
Türkiye

Publication Date

June 1, 2019

Submission Date

December 18, 2018

Acceptance Date

February 4, 2019

Published in Issue

Year 2019 Volume: 26 Number: 2

DOI

https://doi.org/10.17343/sdutfd.499151

IZ

https://izlik.org/JA87NJ48YC

Cite

RIS / Bibtex

APA

Yuksel, Y. (2019). ÜRETER DUBPLİKASYONLU GREFT BÖBREKLERDE NAKİL TECRÜBEMİZ. Medical Journal of Süleyman Demirel University, 26(2), 195-200. https://doi.org/10.17343/sdutfd.499151

AMA

1.Yuksel Y. ÜRETER DUBPLİKASYONLU GREFT BÖBREKLERDE NAKİL TECRÜBEMİZ. Med J SDU. 2019;26(2):195-200. doi:10.17343/sdutfd.499151

Chicago

Yuksel, Yucel. 2019. “ÜRETER DUBPLİKASYONLU GREFT BÖBREKLERDE NAKİL TECRÜBEMİZ”. Medical Journal of Süleyman Demirel University 26 (2): 195-200. https://doi.org/10.17343/sdutfd.499151.

EndNote

Yuksel Y (June 1, 2019) ÜRETER DUBPLİKASYONLU GREFT BÖBREKLERDE NAKİL TECRÜBEMİZ. Medical Journal of Süleyman Demirel University 26 2 195–200.

IEEE

[1]Y. Yuksel, “ÜRETER DUBPLİKASYONLU GREFT BÖBREKLERDE NAKİL TECRÜBEMİZ”, Med J SDU, vol. 26, no. 2, pp. 195–200, June 2019, doi: 10.17343/sdutfd.499151.

ISNAD

Yuksel, Yucel. “ÜRETER DUBPLİKASYONLU GREFT BÖBREKLERDE NAKİL TECRÜBEMİZ”. Medical Journal of Süleyman Demirel University 26/2 (June 1, 2019): 195-200. https://doi.org/10.17343/sdutfd.499151.

JAMA

1.Yuksel Y. ÜRETER DUBPLİKASYONLU GREFT BÖBREKLERDE NAKİL TECRÜBEMİZ. Med J SDU. 2019;26:195–200.

MLA

Yuksel, Yucel. “ÜRETER DUBPLİKASYONLU GREFT BÖBREKLERDE NAKİL TECRÜBEMİZ”. Medical Journal of Süleyman Demirel University, vol. 26, no. 2, June 2019, pp. 195-00, doi:10.17343/sdutfd.499151.

Vancouver

1.Yucel Yuksel. ÜRETER DUBPLİKASYONLU GREFT BÖBREKLERDE NAKİL TECRÜBEMİZ. Med J SDU. 2019 Jun. 1;26(2):195-200. doi:10.17343/sdutfd.499151