PTU - Polskie Towarzystwo Urologiczne
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Article published in Urologia Polska 1999/52/2.


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


kidney aorto-ilio-femoral by-pass grafting, late complications ureteral obstruction hydronephrosis


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.


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