Abstract：Objective:To compare the effect of different double J tube indwelling durations on ureteral lithotripsy after flexible ureteroscopic lithotripsy and the incidence of complications. Methods:According to the inclusion criteria and the time of extubation, a prospective study was conducted on 140 patients who were randomly divided into one-week extubation group and four-week extubation group, 70 cases in each group. The stone clearance rate and the incidence of complications were compared and analyzed between the two groups. Probability (P) value of less than 0.05 was taken to indicate statistical significance. Results:The stone size in one-week extubation group and four-week extubation group was (1.6±0.3) and (1.5±0.4) cm (P>0.05), respectively. The incidence of urinary tract infection and bladder irritation complication in four-week extubation group was significantly higher than that in one-week extubation group (P<0.05). There was no significant difference in the incidence of low back pain and hematuria between the two groups (P>0.05). After 1 month, the total stone clearance rates in one-week extubation group and four-week extubation group were 88.6% (62/70) and 94.2% (66/70) (P>0.05). Conclusions:One-week indwelling time after flexible ureteroscopy combined with holmium laser lithotripsy indwelling double J tube is safe and effective, which reduces the incidence of complications without affecting the residual stone clearance rate.
[1] Ding J, Xu D, Cao QF, et al.Comparing the efficacy of a multimodular flexible ureteroscope with its conventional counterpart in the management of renal stones. Urology, 2015,86(2):224-229. [2] Karadag MA, Demir A, Cecen K, et al.Flexible ureterorenoscopy versus semirigid ureteroscopy for the treatment of proximal ureteral stones: a retrospective comparative analysis of 124 patients. Urol J, 2014,11(5):1867-1872. [3] Pais J, Smith RE, Stedina EA.Does omission of ureteral stents increase risk of unplanned return visit? A systematic review and Meta-Analysis. J Urol, 2016,196(5):1458-1466. [4] 董传江,谢宗兰,张路生,等.软性输尿管镜与经皮肾镜碎石术治疗直径≥2 cm 肾结石疗效比较. 微创泌尿外科杂志,2016,5(4):196-198. [5] 马建伟. 输尿管软镜碎石技术新进展.国际泌尿系统杂志,2012,32(2):254-257. [6] Zimskind PD, Fetter TR, Wilkerson JL.Clinical use of long-term indwelling silicone rubber ureteral splints inserted cystoscopically. J Urol, 1967,97(5):840-844. [7] Finney RP.Experience with new double J ureteral catheter stent. J Urol, 1978,120(6):678-681. [8] 高子剑,刘龙,孙永明,等.输尿管软镜联合钬激光碎石术后双J管留置时间与并发症研究.安徽医药,2014,18(8):1478-1480. [9] 杨炜青,李逊,何永忠,等.输尿管软镜碎石术前留置双J管的随机对照研究.中华腔镜泌尿外科杂志(电子版),2016,10(2):26-29. [10] 兰卫华,王洛夫,李家宽,等.输尿管镜碎石术后输尿管内支架管最佳拔管时间的随机临床研究.中国内镜杂志,2012,18(11):1147-1150. [11] 李九智,宋超,文彬.坦索罗新联合琥珀酸索利那新在预置双J管病例的作用分析.国际泌尿系统杂志,2015,35(5):700-702. [12] Koprowski C, Kim C, Modi PK.Ureteral Stent-Associated Pain: A Review. J Endourol, 2016,30(7):744-753. [13] Picozzi SC, Ricci C, Stubinski R, et al.Is stone diameter a variable in the decision process of employing a ureteral stent in patients undergoing uncomplicated ureterorenoscopy and associated intracorporeal lithotripsy? World J Urol, 2013,31(6):1617-1625. [14] Ozyuvali E, Resorlu B, Oguz U, et al.Is routine ureteral stenting really necessary after retrograde intrarenal surgery? Arch Ital Urol Androl, 2015,87(1):72-75. [15] El-Nahas AR, El-Assmy AM, Shoma AM, et al.Self-retaining ureteral stents: analysis of factors responsible for patients' discomfort. J Endourol, 2006,20(1):33-37. [16] 施云峰,李维国,张捷,等.双J管留置时间对输尿管结石并感染患者疗效的影响.中华医学杂志,2016,96(32):2588-2591. [17] 查泽玉. 留置双J管后分期输尿管软镜手术时机选择的动物实验研究.安徽:蚌埠医学院,2014. [16] Clavica F, Zhao X, Elmahdy M, et al.Investigating the flow dynamics in the obstructed and stented ureter by means of a biomimetic artificial model. PLoS One, 2014,9(2):e87433.
