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Böbrek Nakli Hastalarında Seçilmiş Olgularda Üreter Stent Kullanımının Ürolojik Komplikasyonlar Üzerine Etkisi

The Effect of the Use of Ureteric Stents on Urological Complications in Selected Kidney Transplant Cases

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 2011
DOI: 
DOI 10.5262/tndt.2011.1001.14

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
OBJECTIV ES: The routine use of a ureteric stent remains controversial due to high incidence of its complications. In our routine practice, we prefer selective stenting of problematic anastomoses. The aim of this study is to evaluate incidence of major urological complications in recipients with selective ureteral stenting and without ureteral stenting. MA TERIAL and M ETHODS: We retrospectively reviewed 236 patients who received a kidney transplant (144 living related, 88 cadaver) in our clinic between 2001 and 2009. All patients underwent extravesical Lich-Gregoir ureteroneocystostomy. Ureteral stenting had been used only in patients who had a high risk of urological complications. RESUL TS: A total of 236 kidney transplantation had been performed between 2001 and 2009. Of these 236 patients, a total of 6 were excluded due to primary non-function. Of the remaining 230 procedures, 164 (71%) performed without ureteral stent. Overall 17 (7.4%) urological complications were observed. Urological complication rates were 6.1% and 10.6 % in the non-stented and selectively stented group, respectively. In the living related donor group, a total of 6 patients (4.2%) had urological complications. Urological complications further decreased to 3.3% in patients who received a living donor kidney without stenting. CONCLU SIONS: Kidney transplantation without ureteric stenting is safe in patients at low risk for urological complications. We prefer stentless ureteroneocystostomy surgery in low risk living related kidney transplantation. Selective ureteral stenting may be recommended high risk group for urological complications.
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Abstract (Original Language): 
AMA Ç: Böbrek nakli hastalarında rutin üreteral stent kullanılması komplikasyonları nedeni ile tartışmalıdır. Kliniğimizde sadece sorun olabilecek seçilmiş olgularda üreteral stent kullanılmaktadır. Bu çalışmanın amacı seçilmiş olgularda üreteral stent kullanılan ve stent kullanılmayan böbrek nakli hastalarında üreteral kaçak ve darlık gibi majör ürolojik komplikasyonları değerlendirmektir. GEREÇ ve YÖN TEML ER: Kliniğimizde 2001-2009 yılları arasında yapılan 236 hastanın dosya kayıtları geriye dönük olarak değerlendirilmiş, ürolojik komplikasyonlar not edilmiştir.Tüm hastaların üreter anastomozları ekstravezikal Lich-Gregoir üreteroneosistostomi tekniği kullanılarak yapılmıştır. Sadece ürolojik komplikasyonlar açısından yüksek riskli hastalarda üreteral stent kullanılmıştır. BUL GULA R: Toplam 236 hastanın 230’u değerlendirmeye alınmıştır. Altı hasta birincil nonfonksiyon nedeni ile değerlendirme dışı bırakılmıştır. Hastaların 164’ünde (%71) üreteroneosistostomi stent yerleştirilmeden yapılmıştır. Toplam 17 hastada (%7,4) ürolojik komplikasyon gözlenmiş olup stent kullanılmayan hastalarda bu oran %6,1, stentli hastalarda ise %10,6 bulunmuştur. Canlı vericili nakillerde ürolojik komplikasyon 6 hastada (%4,2) gözlenmiş olup, stent kullanılmayan canlı vericili nakillerde 4 hastada ürolojik komplikasyon oluşmuştur (%3,3). SONU Ç: Böbrek nakilli hastalarda ürolojik risk açısından düşük riskli hastalarda stent kullanmadan dikkatli bir cerrahi yaklaşımla başarılı sonuçlar elde edilebilir. Biz düşük riskli canlı nakillerde stentlerin neden olabileceği komplikasyonları önlemek amacı ile stent kullanmadan nakil yapmayı yeğliyoruz. Seçilmiş yüksek riskli olgularda üreteral stent kullanımı komplikasyonları azaltabilir.
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