Progress in self-expanding metallic ureteral stent in the treatment of ureteral stricture in renal allografts
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摘要: 移植肾输尿管狭窄是肾移植受者常见的术后并发症之一，由于移植肾输尿管较短，重建手术前应先采用腔内治疗以避免不可逆性损伤。治疗此类狭窄的重点是尽可能减少移植肾损伤、解除梗阻或建立引流通道。腔内治疗中，球囊扩张术和内切开术的狭窄复发率较高，而自膨式输尿管金属支架长期留置或许是较好的选择。相较于传统支架，金属支架可长期保持尿路通畅，减少下尿路症状刺激，但适应证和疗效等各有不同。尽管所有金属支架均可能发生支架移位、堵塞，但总体上对移植肾输尿管狭窄治疗仍有积极意义。本文主要介绍自膨式输尿管金属支架在移植肾输尿管狭窄中的应用，以期为优化移植肾输尿管狭窄的治疗提供参考。Abstract: Ureteral stricture in renal allografts is one of the common postoperative complications in kidney transplant recipients. Due to short ureter in renal allografts, endovascular treatment should be adopted before reconstruction surgery to avoid irreversible injury. Alleviating renal allograft injury, easing obstruction or establishing drainage channel are the key measures to treat ureteral stricture. In endovascular treatment, balloon dilatation and internal incision yield high recurrence rate, and long-term indwelling of self-expanding metallic ureteral stents may be a better option. Compared with traditional stents, metallic stents may maintain urinary tract patency for a long time and mitigate the irritation of lower urinary tract symptoms,with different indications and efficacy. Although all metallic stents may be displaced and occluded, it still plays a positive role in the treatment of ureteral stricture in renal allografts. In this article, the application of self-expanding metallic ureteral stent in ureteral stricture of renal allografts was mainly illustrated, aiming to provide reference for optimizing the treatment of ureteral stricture in renal allografts.
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Key words:
- Kidney transplantation /
- Ureteral stricture /
- Ureteral stent /
- Internal incision /
- Balloon dilatation /
- Graft loss /
- Displacement /
- Occlusion
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