USE OF SMALL AND LARGE BOWEL IN RENAL TRANSPLANTATION - 11/09/11
Résumé |
Renal transplantation remains the treatment of choice for properly selected patients with end-stage renal disease (ESRD). The ultimate goal of the urologic surgeon involved in renal transplantation procedures is to provide vascular continuity as well as a watertight, nonrefluxing anastomosis between the allograft ureter and the recipient bladder for urinary tract continuity.
Because of its continued success, renal transplantation is a popular therapeutic modality that has expanding indications, including for the patient with ESRD secondary to lower urinary tract disease, such as the neurogenic or contracted postinflammatory bladder. These patients have a bladder that is not suitable for urinary storage and micturition or they have already undergone urinary reconstruction with either an enteric urinary conduit or continent urinary reservoir.
This article focuses on the use of small and large intestinal segments for urinary tract continuity for renal allograft recipients. These enteric segments can be used for bladder substitution as mentioned or for ureteral or renal pelvic substitution as is seen with vascular or procurement injury to the renal allograft. The surgical procedures used and potential complications are presented for this unique group of patients requiring urinary diversion.
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Address reprint requests to Michael J. Malone, MD Lahey Hitchcock Medical Center 41 Mall Road Burlington, MA 01805 |
Vol 24 - N° 4
P. 837-843 - novembre 1997 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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