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带抗反流装置的双J支架预防尸体肾移植术后短期泌尿系统并发症:单中心前瞻性随机研究

Double J stent with antireflux device in the prevention of short-term urological complications after cadaveric kidney transplantation: single-center prospective randomized study.

作者信息

Battaglia M, Ditonno P, Selvaggio O, Palazzo S, Bettocchi C, Peschechera R, Di Paolo S, Stallone G, Schena A, Grandaliano G, D'Orazio E, Selvaggi F P

机构信息

Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy.

出版信息

Transplant Proc. 2005 Jul-Aug;37(6):2525-6. doi: 10.1016/j.transproceed.2005.06.107.

Abstract

The placement of a double J stent to protect a uretero-vesical anastomosis in a kidney transplant is a widespread procedure performed to reduce the incidence of fistula and stenosis at the anastomosis. However, the presence of a double J stent may cause vesicoureteral reflux (VUR), predisposing one to urinary tract infections (UTIs), which may be a significant source of morbidity for the graft. We evaluated whether a ureteral stent incorporating an antireflux device can reduce the incidence of ureteral reflux and UTIs. From January to December 2003, 44 kidney transplant recipients were randomized to receive a 14-cm 4.8-F double J stent with (group A) or without an anti-reflux device (group B). Primary end points were the reduction of the incidence of VUR and of UTIs. The secondary end point was the graft function, on the basis of mean serum creatinine level at 3, 6, and 12 months. We failed to observe statistically significant differences in terms of either the incidence of VUR and UTIs, or the short-term outcomes of the grafts. We concluded that the anti-reflux device does not have an impact on the incidence of stent-related side effects.

摘要

在肾移植中放置双J支架以保护输尿管膀胱吻合口是一种广泛实施的手术,目的是降低吻合口处瘘管和狭窄的发生率。然而,双J支架的存在可能会导致膀胱输尿管反流(VUR),使人易患尿路感染(UTI),而尿路感染可能是移植物发病的一个重要来源。我们评估了一种带有抗反流装置的输尿管支架是否能降低输尿管反流和尿路感染的发生率。2003年1月至12月,44名肾移植受者被随机分组,分别接受带(A组)或不带抗反流装置(B组)的14厘米4.8F双J支架。主要终点是降低VUR和UTI的发生率。次要终点是根据3、6和12个月时的平均血清肌酐水平评估移植物功能。我们未观察到VUR和UTI的发生率或移植物短期结局方面有统计学显著差异。我们得出结论,抗反流装置对支架相关副作用的发生率没有影响。

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