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dc.contributor.authorSaidi, Reza F.
dc.contributor.authorElias, Nahel
dc.contributor.authorHertl, Martin
dc.contributor.authorKawai, Tatsuo
dc.contributor.authorCosimi, A. Benedict
dc.contributor.authorKo, Dicken S.
dc.date2022-08-11T08:08:31.000
dc.date.accessioned2022-08-23T15:57:50Z
dc.date.available2022-08-23T15:57:50Z
dc.date.issued2013-05-01
dc.date.submitted2013-06-18
dc.identifier.citationJ Surg Res. 2013 May 1;181(1):156-9. doi: 10.1016/j.jss.2012.05.043. <a href="http://dx.doi.org/10.1016/j.jss.2012.05.043">Link to article on publisher's site</a>
dc.identifier.issn0022-4804 (Linking)
dc.identifier.doi10.1016/j.jss.2012.05.043
dc.identifier.pmid22683078
dc.identifier.urihttp://hdl.handle.net/20.500.14038/30292
dc.description.abstractPURPOSE: Ureteroneocystostomy (UCN) is the most widely used urinary reconstruction technique during kidney transplantation. Disadvantages of this technique include a high incidence of hematuria and reflux, plus the potential for obstruction resulting from distal ureteral fibrosis. Pyeloureterostomy (PU) avoids these complications but increases the technical complexity. METHODS: Between January 1990 and December 2005, 1066 adults patients underwent kidney transplantations; 768 patients (72.1%) had urinary reconstruction by PU and 298 (27.9%) underwent UNC. RESULTS: Patients in the PU group underwent simultaneous ipsilateral native nephrectomy. The operative time was longer in the PU group compared with the UNC group: 210 +/- 36 min versus 182 +/- 24 min (P < 0.001). Overall surgical complications in the PU group were comparable to those in the UNC group (9.5% versus 12.3%). The urinary complication rate was also comparable in both groups: 3.2% (25 of 768) in the PU group and 5% (15 of 298) in the UNC group. However, urinary obstruction comprised 60% of urinary complications in the UNC group, compared with 32% in the PU group (P < 0.01). We treated most urinary complications non-operatively. However, 24% of patients (six of 25) in the PU group needed operative intervention or revision for ureteral reconstruction, compared with 46.6% (seven of 15) in the UNC group (P < 0.01). CONCLUSIONS: Pyeloureterostomy is a safe and effective method for urinary tract reconstruction in renal transplantation. Pyeloureterostomy should be part of every transplant surgeon's armamentarium.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=22683078&dopt=Abstract">Link to Article in PubMed</a>
dc.relation.urlhttp://dx.doi.org/10.1016/j.jss.2012.05.043
dc.subjectAdult
dc.subjectAged
dc.subjectCystostomy
dc.subjectFemale
dc.subjectHumans
dc.subjectKidney Transplantation
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectRetrospective Studies
dc.subjectUreter
dc.subjectUreterostomy
dc.subjectHepatology
dc.subjectSurgery
dc.subjectSurgical Procedures, Operative
dc.subjectUrology
dc.titleUrinary reconstruction after kidney transplantation: pyeloureterostomy or ureteroneocystostomy
dc.typeJournal Article
dc.source.journaltitleThe Journal of surgical research
dc.source.volume181
dc.source.issue1
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/faculty_pubs/55
dc.identifier.contextkey4236686
html.description.abstract<p>PURPOSE: Ureteroneocystostomy (UCN) is the most widely used urinary reconstruction technique during kidney transplantation. Disadvantages of this technique include a high incidence of hematuria and reflux, plus the potential for obstruction resulting from distal ureteral fibrosis. Pyeloureterostomy (PU) avoids these complications but increases the technical complexity.</p> <p>METHODS: Between January 1990 and December 2005, 1066 adults patients underwent kidney transplantations; 768 patients (72.1%) had urinary reconstruction by PU and 298 (27.9%) underwent UNC.</p> <p>RESULTS: Patients in the PU group underwent simultaneous ipsilateral native nephrectomy. The operative time was longer in the PU group compared with the UNC group: 210 +/- 36 min versus 182 +/- 24 min (P < 0.001). Overall surgical complications in the PU group were comparable to those in the UNC group (9.5% versus 12.3%). The urinary complication rate was also comparable in both groups: 3.2% (25 of 768) in the PU group and 5% (15 of 298) in the UNC group. However, urinary obstruction comprised 60% of urinary complications in the UNC group, compared with 32% in the PU group (P < 0.01). We treated most urinary complications non-operatively. However, 24% of patients (six of 25) in the PU group needed operative intervention or revision for ureteral reconstruction, compared with 46.6% (seven of 15) in the UNC group (P < 0.01).</p> <p>CONCLUSIONS: Pyeloureterostomy is a safe and effective method for urinary tract reconstruction in renal transplantation. Pyeloureterostomy should be part of every transplant surgeon's armamentarium.</p>
dc.identifier.submissionpathfaculty_pubs/55
dc.contributor.departmentDepartment of Surgery
dc.source.pages156-9


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