[Laparoscopic ureteral reimplantation in the treatment of urinary tract complications after renal transplantation]

Arch Esp Urol. 2017 May;70(4):422-428.
[Article in Spanish]

Abstract

Objectives: Laparoscopic ureteral reconstructive surgery is routinely performed , because it demonstrated efficacy and safety profiles similar to open surgery in expert hands. The most frequent surgical complications after transplant are urological, appearing in up to 12,5% of the cases; they can compromise graft function and mortality. The most frequent ones include ureterovesical anastomosis stenosis (2,5-7,5%) and vesicoureteral reflux (0,4-2,2), which present in up to 80% of the cases.

Methods: Technical description of the Lich-Gregoire ureteral reimplantation technique in renal transplant patients.

Results: From October 2012 we performed 14 Lich-Gregoire laparoscopic ureteral reimplantations in transplant patients, 9 due to distal ureteral stenosis and 5 for vesicoureteral reflux. There were not open conversions.

Conclusions: Laparoscopic surgery has evolved much allowing the performance on techniques that we could not think of years ago. Renal transplant patients present frequent postoperative complications, so they benefit of minimally invasive surgery such as endoscopy or laparoscopy. The Lich-Gregoire laparoscopic reimplantation in transplant patients is reproducible in Centers with experience both in laparoscopic surgery and transplantation.

MeSH terms

  • Humans
  • Kidney Transplantation*
  • Laparoscopy*
  • Postoperative Complications / surgery*
  • Ureter / surgery*
  • Ureteral Obstruction / surgery*
  • Urologic Surgical Procedures / methods
  • Vesico-Ureteral Reflux / surgery*