KẾT QUẢ LÂU DÀI CỦA CÁC BỆNH NHÂN CÓ BIẾN CHỨNG HẸP NIỆU QUẢN THẬN GHÉP

Abstract

Objective: To evaluate the outcomes of treating complications of ureteral stricture after kidney transplantation. Patients and Research Methods: Retrospective description of 33 patients diagnosed with ureteral stricture after kidney transplantation through clinical assessment and computed tomography imaging. Study parameters: Gender, source of the transplanted kidney, duration of ureteral stricture, previous interventions, method of ureteral stent placement, open surgery or endoscopy, right/left kidney, location of the stricture, causes of stricture, treatment methods, treatment outcomes after 1 month, 3 months, and 1 year. Results: 22 males to 11 females. 93.93% of the kidneys were procured from living donors, while 6.07% were from deceased donors. Endoscopic surgery was used for kidney retrieval in 78.78% of cases, while open surgery accounted for 21.22%. The right kidney was donated in 69.69% of cases. All patients with strictures had dilated renal pelvis on ultrasound and higher blood creatinine levels than baseline. The majority (66.67%) developed ureteral stricture within 1 month post-transplantation. Dilatation of the renal pelvis > 2cm on ultrasound accounted for 60.61%. The most common site of stricture on CT imaging was at the ureter-bladder anastomosis, accounting for 75.75%. Balloon dilation of the ureteral stricture was successful in 6.07% of cases. The remaining cases underwent open surgery after failed balloon dilation (24.24%) or directly upon diagnosis (69.69%). Placing the transplant ureteral stent into the native ureter was the preferred technique in 87.1% of cases, with 13% requiring additional suturing to prevent retrograde infection. Normal renal function and resolution of infection were achieved in all cases. Conclusion: Open surgery is indicated for long or failed endoscopic treatment of strictures. Placement of ureteral stents may not always be technically feasible or effective.