Ghép thận tự thân cho bệnh nhân tổn thương mất đoạn niệu quản: báo cáo 2 trường hợp lâm sàng ở Bệnh Viện Trung Ương Huế

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Tác giả: Vương Thắng Hoàng, Nguyên Kha Lê, Văn Hiếu Lê, Kim Tuấn Nguyễn, Văn Quốc Anh Nguyễn, Ngọc Hùng Phạm, Hữu Quốc Việt Phan, Minh Tuấn Trương, Văn Cẩn Trương

Ngôn ngữ: vie

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Thông tin xuất bản: Tạp chí Y học lâm sàng Bệnh viện Trung ương Huế, 2024

Mô tả vật lý: tr.68-77

Bộ sưu tập: Metadata

ID: 372042

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Chúng tôi báo cáo 2 trường hợp ghép thận tự thân cho bệnh nhân mất niệu quản dài đoạn trên tại Bệnh viện Trung Ương Huế. Tình trạng tổn thương niệu quản xảy ra do biến chứng của phẫu thuật trước đó như nội soi ngược dòng tán sỏi niệu quản và nội soi sau phúc mạc cắm lại niệu quản vào bàng quang kèm lấy sỏi niệu quản. Hai bệnh nhân được phẫu thuật lấy thận có tổn thương niệu quản ghép vào hố chậu đối bên: ghép động mạch thận vào động mạch chậu ngoài, tĩnh mạch thận vào tĩnh mạch chậu ngoài theo phương pháp nối tận bên và tạo hình niệu quản bằng phương pháp Boari (trường hợp 1) và phương pháp Lich - Gregoir (trường hợp 2). Cả 2 bệnh nhân xuất viện sau 2 tuần và được rút thông JJ sau 1 tháng. Theo dõi sau phẩu thuật 2 bệnh nhân hoàn toàn khỏe mạnh, các chỉ số của thận ghép nằm trong giới hạn bình thường. Thành công của 2 trường hợp này là tiền đề để chúng tôi có thể áp dụng phương pháp ghép thận tự thân cho những trường hợp mất đoạn niệu quản lớn, bệnh lý mạch máu thận phức tạp, u thận lớn, sỏi thận lớn.We report 2 cases of kidney autotransplant for patients with long loss of upper ureter at Hue Central Hospital. Ureteral injury occurs due to complications of previous surgery such as endoscopic retrograde lithotripsy and retroperitoneal re - insertion of the ureter into the bladder with ureteral stone removal. Two patients had kidney surgery with ureteral lesions grafted into the contralateral iliac fossa: renal artery transplantation into the external iliac artery, renal vein into the external iliac vein by end - to - side anastomography and ureteroscopy by Boari flap (case 1) and Lich - Gregoir procedure (case 2). Both patients were discharged after 2 weeks, and the JJ catheter was removed after 1 month. Post - operative follow - up 2 patients were completely healthy, the parameters of the transplanted kidney were within normal level. The success is a premise for us to indicate kidney autotransplant incase long ureteral loss, complicated renal vascular disease, large kidney tumor, large kidney stone.

1. Đọc trực tuyến

1. Đọc trực tuyến

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