Ozkan Orhan, Akinci Devrim, Bozlar Uğur, Ustünsöz Bahri, Ozmen Mustafa, Akhan Okan
Department of Radiology, Hacettepe University School of Medicine, Ankara, Turkey.
Diagn Interv Radiol. 2009 Mar;15(1):51-6.
The aim of this study was to assess the safety and efficacy of fluoroscopy-guided retrograde double-J stent exchange.
Between March 2003 and June 2005, 39 retrograde ureteral stent exchange procedures on 19 patients and 24 ureters were performed under fluoroscopic guidance. Seventeen of the patients were female and 2 were male. All procedures were done on an outpatient basis unless the patient was already an inpatient. All exchanges were performed through 10 F introducer sheaths. Once the stent was grasped, the sheath, the snare and/or the wire holding the stent were pulled out as a unit. For retrieving the stents, several different techniques (guide wire lasso and wire snaring) were used in addition to simple snare technique. Two parallel stents were placed for each ureter in 2 patients (3 ureters) after a history of stent occlusion in less than 3 months.
Technical success rate was 100%. Procedure time ranged from 16 to 38 minutes (average, 21 min). There were no major complications. All patients had minor hematuria after the procedure which resolved within one day.
Fluoroscopy-guided retrograde double-J stent exchange is a safe and effective procedure and can easily be performed with equipment and techniques used in daily interventional practice.
本研究旨在评估透视引导下逆行双J管支架置换术的安全性和有效性。
2003年3月至2005年6月期间，在透视引导下对19例患者的24条输尿管进行了39次逆行输尿管支架置换手术。患者中17例为女性，2例为男性。除非患者已住院，所有手术均在门诊进行。所有置换均通过10F引导鞘完成。一旦抓住支架，将鞘、圈套器和/或固定支架的导丝作为一个整体拔出。为取出支架，除了简单的圈套技术外，还使用了几种不同的技术（导丝套索和钢丝圈套）。在2例患者（3条输尿管）中，既往支架在不到3个月内发生阻塞，为每条输尿管放置了两个平行的支架。
技术成功率为100%。手术时间为16至38分钟（平均21分钟）。无重大并发症。所有患者术后均有轻微血尿，一天内消退。
透视引导下逆行双J管支架置换术是一种安全有效的手术，使用日常介入操作中的设备和技术即可轻松完成。
