[Follow-up evaluation of a new ureteral anastomosis technique in renal transplantation].
OBJECTIVE
To compare the therapeutic effect of new "One-Stitch" ureterovesical anastomosis to that of the classic Lich-Gregoir method.


METHODS
From January 2002 to December 2004, 445 patients suffering from uremia due to chronic nephritis were treated with renal transplantation. Among them, 121 patients were operated with our new modified ureteroneocystostomy technique (the new One-Stitch group), and 324 patients were operated with Lich-Gregoir technique (the Lich-Gregoir group). In the new One-Stitch group, there were 79 males and 42 females, aged 20-62 years (35.7 years on average). The course of the disease was 2-11 years (2.7 years on average). In the Lich-Gregoir group, there were 211 males and 113 females, aged 19-65 years (33.9 years on average). The disease course was 1-14 years (2.3 years on average). There was no significant difference between the two groups in age, proportion of genders, primary diseases and course of the disease (P > 0.05). The operative time, the ureteral complications and non-ureteral complications were compared between the two groups after the renal transplantation.


RESULTS
The operative time for the new One-Stitch and Lich-Gregoir techniques was (8.7 +/- 1.1) minutes and (22.4 +/- 5.1) minutes, indicating the difference was significant (P < 0.05). All recipients were followed up for 3-5 years. In the new One-Stitch group, there were 5 patients with leakage of urine, 15 with gross hematuria, 4 with ureteral obstruction and 28 with urinary system infection. Symptomatic vesicoureteral reflux and stone formation were not observed in this group. In the Lich-Gregoir group, there were 17 patients with leakage of urine, 12 with gross hematuria, 13 with ureteral obstruction, 86 with urinary system infection, 6 with symptomatic vesicoureteral reflux and 2 with stones. In the new One-Stitch group, the incidence rate of complications of gross hematuria was 12.4%, which was significantly different from 3.7% in the Lich-Gregoir group (P < 0.05). The incidence rates of ureteral complications in the Lich-Gregoir and the new One-Stitch groups were 19.8% and 15.4%, respectively. The difference was not significant (P > 0.05). There was no significant difference between the two groups in incidence rate of urinary system infection, delayed recovery of kidney function after kidney transplantation and rejection reaction (P > 0.05).


CONCLUSIONS
The new One-Stitch group has no significant difference in ureteral complications compared with the Lich-Gregoir group, and has become a preferential ureterovesical reimplantation technique because of its simple and has convenient operation.
Pan
Xiaoming
X
Department of Kidney Transplantation, Nephrology Center, the First Affiliated Hospital, Medical College of Xi'an Jiaotong University, Xi'an Shaanxi, PR China. panxiaoming@medmail.com.cn
Xue
Wujun
W
Tian
Puxun
P
Ding
Xiaoming
X
Yan
Hang
H
Feng
Xinshun
X
Hou
Jun
J
Xiang
Heli
H
D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016030:Kidney Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009393:Nephritis / Q000601:surgery; D014513:Ureter / Q000601:surgery*