PMC7381963_01
Perioperative clinical course. Cre: creatinine; FXIII: factor XIII; IVIG: intravenous immunoglobulin; POD: postoperative day.
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The Lich-Gregoir method was adopted without the use of a ureteral stent (Figure 1).
On postoperative day 5, fluid collection around the graft kidney is detected on computed tomography. Further, this fluid is not derived from the rupture of the anastomosis. Cystography reveals no leakage from the anastomosis.
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Computed tomography (CT) revealed fluid collections in the right postperitoneal cavity (Figure 2).
On surgical examination, urine is seen overflowing from the incision, and increased urine is seen around the graft kidney leaking from a tiny hole in the middle portion of the ureter.
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On surgical examination performed on POD 8, we noted a small perforation in the middle portion of the right ureter (Figure 3).
After native nephrectomy, reconstruction is performed with pyeloureteral anastomosis. A running suture is placed in a watertight manner with 3-0 vicryl after placing a double-J ureteral stent. After surgery, computed tomography revealed no residual urine around the graft.
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Further, pyeloureteral neoanastomosis was performed using 3-0 vicryl with a ureteral stent and drainage tube (Figure 4).
On postoperative day 14, urine leakage is not obvious on cystography. Further, computed tomography revealed no signs of leakage after removal of the drainage tube.
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Behring, King of Prussia, PA) was administered for 5 days, which led to reduced drainage. Because there were no signs of leakage (Figure 5), the ureteral catheter and drainage tube were removed.