Giakoustidis D, Diplaris K, Antoniadis N, Papagianis A, Ouzounidis N, Fouzas I, Vrochides D, Kardasis D, Tsoulfas G, Giakoustidis A, Miserlis G, Imvrios G, Papanikolaou V, Takoudas D
Department of Transplant Surgery, School of Medicine, Aristotle University, Hippokration Hospital, Thessaloniki, Greece.
Transplant Proc. 2008 Nov;40(9):3173-5. doi: 10.1016/j.transproceed.2008.08.064.
We retrospectively evaluated the use of double-j stent and the incidence of urological complications in 2 groups of patients who received a kidney transplant. From January 2005 to September 2007 we studied 172 patients receiving kidney transplants, 65 and 107 from living and cadaver donors, respectively. From the 172 patients, a total of 34 were excluded due to ureterostomy or Politano-Leadbetter ureterovesical anastomosis. Another 21 patients were excluded from the study due to graft loss due to acute or hyperacute rejection, cytomegalovirus (CMV) infection, or vascular complication. The remaining patients were divided into 2 groups: group A (44 patients) and B (73 patients) with versus without the use of a double-j-stent, respectively. The 2 groups were comparable in terms of donor and recipient gender, ischemia time, and delayed graft function. We failed to observes significant differences between the 2 groups in mean hospital stay (23 +/- 9 and 19 +/- 9), urinary leak (2.3% and 4.1%), and urinary tract infection (20.4% and 19.2%), among groups A and B, respectively. The only difference observed concerned the gravity of the urinary leak; no surgical intervention was needed among the double-j stent group versus 2 patients demanding ureterovesical reconstruction in the nonstent group. In conclusion, our data suggested that the routine use of a double-j stent for ureterovesical anastomosis neither significantly increased urinary tract infection rates, nor decreased the incidence of urinary leaks, but may decrease the gravity of the latter as evidenced by the need for surgical intervention.
我们回顾性评估了两组肾移植患者双J支架的使用情况及泌尿系统并发症的发生率。2005年1月至2007年9月，我们研究了172例接受肾移植的患者，其中分别有65例和107例来自活体供体和尸体供体。在这172例患者中，共有34例因输尿管造口术或波利塔诺-利德贝特输尿管膀胱吻合术被排除。另外21例患者因急性或超急性排斥反应、巨细胞病毒（CMV）感染或血管并发症导致移植肾丢失而被排除在研究之外。其余患者分为两组：A组（44例患者）和B组（73例患者），分别使用和未使用双J支架。两组在供体和受体性别、缺血时间及移植肾功能延迟方面具有可比性。我们未观察到A组和B组在平均住院时间（分别为23±9天和19±9天）、尿漏（分别为2.3%和4.1%）及尿路感染（分别为20.4%和19.2%）方面存在显著差异。观察到的唯一差异与尿漏的严重程度有关；双J支架组无需手术干预，而非支架组有2例患者需要进行输尿管膀胱重建。总之，我们的数据表明，输尿管膀胱吻合术中常规使用双J支架既不会显著增加尿路感染率，也不会降低尿漏的发生率，但可能会降低尿漏的严重程度，这一点从手术干预的必要性可以得到证明。
