A nipple-valve technique for ureteroneocystostomy in pediatric kidney transplantation

作者：Van Arendonk Kyle J^*; Goldstein Seth D; Salazar Jose H; Kumar Komal; Lau Henry T; Colombani Paul M

来源：Pediatric Transplantation, 2015, 19(1): 42-47.

DOI：10.1111/petr.12393

• pediatric kidney transplantation
• surgery
• surgical complications
• vesicoureteral reflux
• ureter

The ureteroneocystostomy in kidney transplantation can be performed with a variety of techniques. Over a 20-yr period, we utilized a technique of nipple-valve ureteroneocystostomy for the pediatric kidney transplants performed at our institution. The distal ureter is everted upon itself and anchored in place with four interrupted sutures to create a nipple valve, which is then inserted into the bladder and sewn mucosa-to-mucosa with the same sutures. The muscularis layer is closed around the ureter without tunneling and without routine ureteral stenting. After 109 transplants, patient survival was 97.2, 97.2, and 86.9% at one, five, and 10yr, respectively. Graft survival was 91.7, 71.7, and 53.9% at one, five, and 10yr, respectively. The most common cause of graft loss was acute or chronic rejection, seen in 75% of those experiencing graft loss. Two patients (1.8%) developed pyelonephritis in the transplanted kidney. Nipple-valve ureteroneocystostomy in pediatric kidney transplantation is a safe and simple method for performing the ureterovesical anastomosis with a low rate of pyelonephritis after transplantation.

• 出版日期2015-2