case_images: PMC7381963_01
case_images: Perioperative clinical course. Cre: creatinine; FXIII: factor XIII; IVIG: intravenous immunoglobulin; POD: postoperative day.
case_images: CRIT2020-1780760.001.jpg
case_images: PMC7381963_01_CRIT2020-1780760.001.jpg
case_images: fig1
case_images: The Lich-Gregoir method was adopted without the use of a ureteral stent (Figure 1).
case_images: 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.
case_images: CRIT2020-1780760.002.jpg
case_images: PMC7381963_01_CRIT2020-1780760.002.jpg
case_images: fig2
case_images: Computed tomography (CT) revealed fluid collections in the right postperitoneal cavity (Figure 2).
case_images: 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.
case_images: CRIT2020-1780760.003.jpg
case_images: PMC7381963_01_CRIT2020-1780760.003.jpg
case_images: fig3
case_images: On surgical examination performed on POD 8, we noted a small perforation in the middle portion of the right ureter (Figure 3).
case_images: 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.
case_images: CRIT2020-1780760.004.jpg
case_images: PMC7381963_01_CRIT2020-1780760.004.jpg
case_images: fig4
case_images: Further, pyeloureteral neoanastomosis was performed using 3-0 vicryl with a ureteral stent and drainage tube (Figure 4).
case_images: 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.
case_images: CRIT2020-1780760.005.jpg
case_images: PMC7381963_01_CRIT2020-1780760.005.jpg
case_images: fig5
case_images: 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.