The optimal drainage duration of double J stent after holmium laser lithotripsy under flexible ureteroscopy: A randomized controlled single center study
Zhang Yi1, Yang Sixing1, Song Chao1, Liao Wenbiao1, Liu Lingqi1
1.Department of Urology, Renmin Hospital of Wuhan University, Wuhan 430060, China
Abstract:Objective: To explore the optimal indwelling time of double-J stent after flexible ureteroscopy. Methods: Using randomized controlled methods, 248 patients with kidney stones were selected with the diameter of (12.0±2.15) mm. All patients were preseted double J tube to expand the ureter passively for two weeks. Then the renal stones were treated with flexible ureteroscopy and the F7 double J stent was placed in the ureter postoperatively. In which, 121 patients whose double J stent were removed at 2nd week postoperatively were assigned to experimental group, and 127 patients whose double J stent were removed at 4th week postoperatively were assigned to control group. Computed tomography was done at 2nd week after the double-J stent being removed cystoscopically to assess stone-free rate (SFR). Postoperative complications were recorded. Results: The SFR in the experimental group and control group was 89.26% (108 /121) and 88.19% (112/127) respectively (P>0.05). Gross hematuria, abdomen pain, waist pain, urinary tract infection, irritation sign of bladder were recorded in two groups. There was no significant difference in gross hematuria, abdomen pain as well as waist pain between two groups (P>0.05). The incidence of postoperative complications as urinary tract infection and irritation sign of bladder was statistically higher in the control groups than that in the experimental group (P<0.05). Conclusions: The 4-week indwelling of double J stent may increase the incidence of urinary tract infection and irritation sign of bladder as compared with the 2-week indwelling although the SFR showed no statisticall significant difference.
张义,杨嗣星,宋超,廖文彪,刘凌琪. 软性输尿管镜钬激光碎石术后双J管放置时间的单中心随机对照研究[J]. 微创泌尿外科杂志, 2016, 5(4): 199-202.
Zhang Yi, Yang Sixing, Song Chao, Liao Wenbiao, Liu Lingqi. The optimal drainage duration of double J stent after holmium laser lithotripsy under flexible ureteroscopy: A randomized controlled single center study. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2016, 5(4): 199-202.
[1]孙颖浩,那彦群,叶章群. 中国泌尿外科疾病诊断治疗指南2014版. 北京:人民卫生出版社,2014:428-429. [2]Byrne RR, Auge BK, Kourambas J, et al. Routine ureteral stenting is not necessary after ureteroscopy and ureteropyeloscopy: a randomized trial. J Endourol, 2002,16(1):9-13. [3]Pengfei S, Yutao L, Jie Y, et al. The results of ureteral stenting after ureteroscopic lithotripsy for ureteral calculi: a systematic review and meta-analysis. J Urol, 2011,186(5):1904-1909. [4]Baseskioglu B, Sofikerim M, Demirtas A, et al. Is ureteral stenting really necessary after ureteroscopic lithotripsy with balloon dilatation of ureteral orifice? A multi-institutional randomized controlled study. World J Urol, 2011,29(6):731-736. [5]Cevik I, Dillioglugil O, Akdas A, et al. Is stent placement necessary after uncomplicated ureteroscopy for removal of impacted ureteral stones? J Endourol, 2010,24(8):1263-1267. [6]Shields JM, Bird VG, Graves R, et al. Impact of preoperative ureteral stenting on outcome of ureteroscopic treatment for urinary lithiasis. J Urol, 2009,182(6):2768-2774. [7]Tawfiek ER, Bagley DH. Management of upper urinary tract calculi with ureteroscopic techniques. Urology, 1999,53(1):25-31. [8]Hosking DH, McColm SE, Smith WE. Is stenting following ureteroscopy for removal of distal ureteral calculi necessary? J Urol, 1999,161(1):48-50. [9]Hollenbeck BK, Schuster TG, Seifman BD, et al. Identifying patients who are suitable for stentless ureteroscopy following treatment of urolithiasis. J Urol, 2003,170(1):103-106. [10]Wong KA, Sahai A, Patel A, et al. Is percutaneous nephrolithotomy in solitary kidneys safe? Urology, 2013,82(5):1013-1016. [11]Damiano R, Autorino R, Esposito C, et al. Stent positioning after ureteroscopy for urinary calculi: the question is still open. Eur Urol, 2004,46(3):381-388. [12]Torricelli FC, De S, Hinck B, et al. Flexible ureteroscopy with a ureteral access sheath: when to stent? Urology, 2014,83(2):278-281. [13]Atis G, Gurbuz C, Arikan O, et al. Retrograde intrarenal surgery for the treatment of renal stones in patients with a solitary kidney. Urology, 2013,82(2):290-294. [14]Cheng F, Yu W, Zhang X, et al. Minimally invasive tract in percutaneous nephrolithotomy for renal stones. J Endourol, 2010,24(10):1579-1582. [15]Damiano R, Oliva A, Esposito C, et al. Early and late complications of double pigtail ureteral stent. Urol Int, 2004,69(2):136-140. [16]Joshi HB, Stainthorpe A, Macdonagh RP, et al. Indwelling ureteral stents: evaluation of symptoms, quality of life and utility. J Urol, 2003,169(3):1065-1069. [17]Riedl CR, Witkowski M, Plas E, et al. Heparin coating reduces encrustation of ureteral stents: a preliminary report. Int J Antimicrob Agents, 2002,19(6):507-510. [18]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. [19]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.蚌埠医学院,2014.