[Surveillance of renal function by scintigraphy with 99m Tc-DMSA after a trans-ileal cutaneous ureterostomy].
The renal function of sixty one adult patients was monitored by 99mTc-DMSA renal scan after cystectomy for a malignant tumour followed by ileal conduit urinary diversion. The postoperative follow-up period was 10 years. The stenosis rate of the uretero-ileal anastomosis was 12.8% and the incidence of pyelonephritis was 8% The mean value for overall renal function and for the function of each kidney did not deteriorate significantly (p = 0.1 and p = 0.7, respectively) over time. However, 26% of kidneys evaluated at 1 year and at 5 years showed a markedly decreased uptake on the renogram. In 70% of cases, this decreased uptake was related to the development of stenosis of the uretero-ileal anastomosis or pyelonephritis. Renal function remained stable at 5 years in group A, corresponding to patients with good initial renal function (n = 22, p = 0.07), and in group B, corresponding to patients with poor initial renal function (n = 7, p = 0.9). Similarly, the function of solitary kidneys did not deteriorate over the 5-year postoperative follow-up period (n = 7, p = 0.5). The functional value of the kidneys was therefore not globally altered after ileal conduit urinary diversion. The existence of a mechanical or infectious complication should be systematically investigated in the presence of a deterioration in renal function. DMSA isotope renal scan is a complete, qualitative and quantitative, follow-up examination after this type of urinary diversion.(ABSTRACT TRUNCATED AT 250 WORDS)
Brétheau
D
D
Centre d'urologie Castellane, Marseille.
Ponthieu
A
A
Rossi
I
I
Pasquier
J
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007082:Ileum / Q000637:transplantation*; D015994:Incidence; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D015609:Organotechnetium Compounds; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology; D011704:Pyelonephritis / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology; D011877:Radionuclide Imaging; D004113:Succimer; D019783:Technetium Tc 99m Dimercaptosuccinic Acid; D014517:Ureteral Obstruction / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology; D014547:Urinary Diversion / Q000009:adverse effects*
D015609:Organotechnetium Compounds; D019783:Technetium Tc 99m Dimercaptosuccinic Acid; D004113:Succimer
Surveillance de la fonction rénale par scintigraphie au 99m Tc-DMSA après urétérostomie cutanée trans-iléale.