Comparing Taguchi and Lich-Gregoir Ureterovesical Reimplantation Techniques for Kidney Transplants

Taguchi technique of ureteral implantation was used in 22 kidney transplant patients (group T). Group T was compared with 25 patients who were treated using Lich-Gregoir technique (group LG). Immunosuppression, incidence of biopsy evidenced acute cellular rejection (ACR), haematuria rate and ureteral complications (stricture, reflux) were assessed in both groups. The immunosuppression used was based on cyclosporin A (63.6%), tacrolimus (27.3%) and sirolimus (8.1%) in T group. Cyclosporin A (72%), tacrolimus (20%) and sirolimus (8%) were used in LG group. No induction was used. The incidence of ACR was similar in both groups -T resp. LG was 50% resp. 52%. Haematuria after operation was on average 4.0 days in the T group and on average 3.1 in the LG group. Ureteral complications were observed in 18.2% of cases in T group and in 16% of cases in LG group. No reflux was evidenced in any group. Taguchi technique is fast and very easy to do. A slightly higher incidence of ureteral complications and a longer period of postoperative haematuria were observed in T group. Taguchi technique is very easily performed with a shorter operating time. We advocate it as a method of ureteral implantation on the thin-wall urinary bladder. The results were very good in these cases.

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“…6.8% in Lich-Gregoir resp. Taguchi technique [7][8][9][10]. We have not observed a significantly longer period of haematuria.…”

Section: Discussionmentioning

confidence: 48%

“…We have not observed a significantly longer period of haematuria. Because of a similar rate of urological complications between the Taguchi and Lich-Gregoir techniques some authors recommend Taguchi technique for ordinary use [8,9]. Some other authors prefer Lich-Gregoir technique despite a shorter operation time.…”

Section: Discussionmentioning

confidence: 99%

The Taguchi Technique of the Transplanted Kidney Ureter Implantation – Single Centre Experience

Pacovský

Navrátil

2007

Upsala Journal of Medical Sciences

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“…Haberal et al [28] described a Corner-saving technique as a modification to LG with a result of 2.4% of urological complication (1 urine leakage and 1 ureteral stenosis) in a small study population of 82 cases. Khauli emphasized employment of a ureteric stent and using upper ureter in his modification [29]. Our modification aimed to seal the potential gap surrounding the ureter, at the entrance of ureter to the bladder by additional stitch at each side of ureter with bladder muscular layer.…”

Section: Discussionmentioning

confidence: 99%

Preventable Urological Complications Post Kidney Transplant with Modified Lich-Gregoir Technique for Ureteroneocystostomy

He¹,

Ng²

2016

J Transplant Technol Res

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Aim: Various ureteroneocystostomy techniques for kidney transplant have been described with Lich-Gregoir (LG) being widely employed. However, even with multiple modifications on this technique, urine leakage and ureteric stenosis remain as most common complications. This study aims to evaluate urological complications by using our modified LG technique after kidney transplant. Method: From 26th January 2010 to 30 th May 2014, 206 consecutive kidney transplants were performed at our institute. 124 were deceased-donor and 69 were live-donor kidney transplants; 13 patients received a small tumour excised kidney graft. All transplants except one were done by conventional open surgery. The modification involves an additional stitch placed at proximal part of bladder muscular incision with peri ureteric tissue at the entrance of ureter to bladder. Urological complications were defined as urine leakage or ureteral stricture. The patients were followed-up from 12 to 64 months. Results:There was no urine leakage in this cohort. One case of ipsilateral dual-kidney transplant developed distal ureteral stricture secondary to a lymphocele that was treated by laparoscopic fenestration. Subsequently, surgical reconstruction of urinary tract was required and success. Seven cases had mild to moderate hydronephrosis identified on CDU; 4 were due to a lymphocele; 3 were secondary to urinary tract stones. Four patients had renal pelvis prominence on CDU, which was spontaneously resolved with satisfactory renal function. Conclusion:From this study, it is demonstrated that urine leakage can be prevented and ureteric stricture may be minimised by using this modified LG technique. The ureter was always shortened in an adequate length and a ureteric stent was inserted. This modification is simple and reproducible by placing additional two stitches, which secure the potential gap at the entrance of ureter to the bladder.

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“…Chirurginės komplikacijos išlieka daugelio transplantato nefunkcionavimo ir pacientų sergamumo ankstyvuoju pooperaciniu laikotarpiu priežastimi [9]. Literatūroje yra apibendrinimų, kad apie 50 proc.…”

Section: Rezultatų Aptarimasunclassified

Chirurginės komplikacijos po inkstų transplantacijos

Želvys

Vilimas

Manikas

2015

Medicinos Teorija Ir Praktika

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proc.) pacientai turėjo bent vieną kitą komplikaciją. Dažniausia komplikacija tarp visų pacientų buvo ūminis pielonefritas -9,75 proc., dažniausia komplikacija tarp inkstą iš gyvo donorų gavusių recipientų buvo hematoma -17,5 proc., dažniausia komplikacija tarp inkstą iš kadaverinio donoro gavusių recipientų buvo ūminis pielonefritas ir limfocelė -po 10,2 proc. Nuo išemijos laiko statistiškai patikimai priklausė urosepsio, anastomozės nesandarumo, hematomų, limfocelės komplikacijų dažnis. Ilgėjant išemijos laikui, komplikacijų buvo daugiau. Priklausomai nuo to, kelinta transplantacija pacientui atlikta, duomenys statistiškai reikšmingai koreliavo su ūminiu pielonefritu (p = 0,023) -9,18 proc. atliekant pirmąją transplantaciją, 8,33 proc. atliekant antrąją ir 50 proc. atliekant trečiąją. Nuo transplantuoto inksto akmenligės statistiškai reikšmingai priklausė urosepsio ir pielonefrito dažnis -50 proc. pacientų su inkstų akmenlige sirgo ūminiu pielonefritu, o 25 proc. -sepsiu. Su obstrukcine hidronefroze 63,63 proc. recipientų sirgo ūminiu pielonefritu, o 18,18 proc. -sepsiu. Mūsų duomenimis, urologinių komplikacijų dažniau pasitaikė recipientams, gavusiems inkstą iš kadaverinių nei iš gyvų donorų, nors tai nebuvo statistiškai reikšminga; didėjant amžiui, taip pat daugėjo urologinių komplikacijų. Arterijos trombozė pasitaikė 2,12 proc. recipientų, arterijos stenozė -4,24 proc., venos trombozė -3,81 proc., limfocelė -9,32 proc. Išvados. Chirurginės komplikacijos po inkstų transplantacijos pasitaiko dažnai, tačiau jų dažnis VUL SK neviršyja kitų centrų rodiklių. Kraujavimo sukeltos komplikacijos buvo dažnesnės ir gali būti sąlygotos aktyvios profilaktinės perioperacinės heparinizacijos. Ilgėjant išemijos laikui ir atliekant pakartotines inkstų transplantacijas, komplikacijų daugėja. Esant inkstų akmenligei ir obstrukcinei uropatijai, recipientams dažniau pasireiškė pielonefritas ir sepsis.

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Comparing Taguchi and Lich-Gregoir Ureterovesical Reimplantation Techniques for Kidney Transplants

Cited by 51 publications

References 13 publications

The Taguchi Technique of the Transplanted Kidney Ureter Implantation – Single Centre Experience

The Taguchi Technique of the Transplanted Kidney Ureter Implantation – Single Centre Experience

Preventable Urological Complications Post Kidney Transplant with Modified Lich-Gregoir Technique for Ureteroneocystostomy

Chirurginės komplikacijos po inkstų transplantacijos

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