authors
-
Miłosław Cnotliwy 1, Marek Grabowski 2, Piotr Gutowski 1, Zbigniew Sych 3, Grzegorz Szumiłowicz 1
- 1 Klinika Chirurgii Ogólnej i Naczyniowej Pomorskiej AM w Szczecinie
Kierownik: prof. dr hab. n. med. G. Szumiłowicz
2 Klinika Urologii Pomorskiej AM w Szczecinie
Kierownik: prof. dr hab. n. med. A. Sikorski
3 Zakład Higieny i Epidemiologii Pomorskiej AM w Szczecinie
Kierownik: dr hab. n. med. A. Walczak
keywords
-
kidney aorto-ilio-femoral by-pass grafting, late complications ureteral obstruction hydronephrosis
summary
- Objective. The purpose of this study was to determine an incidence of
- hydroureteronephrosis in patients with late graft-associated complications after
- aortoiliac by-pass surgery.
- Patients and method. From January to November 1998, a series of 79 patients
- who had previously undergone aorto-iliofemoral reconstructive surgery were
- studied retrospectively to determine hydronephrosis. In each patient entered
- into the study a double velour Dallon prosthesis was placed. The mean interval
- between initial grafting procedures and this evaluation was 5 years. The study
- group consisted of 43 patients identified as having graft complications including:
- graft thrombosis [21], anastomoticpseudoaneurysm [16], graft infection [6]. The
- control group consisted of 36 patients with patent grafts without any signs of
- late complications. Real-time ultrasound examination were used and serum urea
- nitrogen and creatinine levels were estimated.
- Results. Unilateral hydronephrosis was found in 3 patients with late graft
- thrombosis and none in the control group. Ultrasonography revealeddistension
- of the pyelocaliceal system confirmed by excretory urograms in two cases and
- aortography in one. All patients were asymptomatic. Ureteral compromise did
- not influence determinations of serum urea nitrogen and creatinine levels.
- Conclusions. The incidence of hydronephrosis in patients with late
- complications following aortofemoral by-pass grafts was 6.9 per cent. Results
- of this study demonstrate the necessity of routine postoperative ultrasound
- scaning to detect ureteral obstruction after aortoiliac reconstruction, particularly
- in patients who develop graft complications.
references
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