Department of Urology, Jeju National University College of Medicine, Jeju, Korea.
Yonsei Med J. 2013 Mar 1;54(2):464-8. doi: 10.3349/ymj.2013.54.2.464.
We review our experience using a new and easily removable ureteral catheter in patients who underwent complicated ureteral reimplantation. Our goal was to shorten hospital stay and lower anxiety during catheter removal without fear of postoperative ureteral obstruction.
Between April 2009 and September 2010, nine patients who underwent our new method of catheter removal after ureteral reimplantation were enrolled. Patients who underwent simple ureteral reimplantation were excluded from the study. Following ureteral reimplantation, a combined drainage system consisting of a suprapubic cystostomy catheter and a ureteral catheter was installed. Proximal external tubing was clamped with a Hem-o-lok clamp and the rest of the external tubing was eliminated. Data concerning the age and sex of each patient, reason for operation, method of ureteral reimplantation, and postoperative parameters such as length of hospital stay and complications were recorded.
Of the nine patients, four had refluxing megaureter, four had a solitary or non-functional contralateral kidney and one had ureteral stricture due to a previous anti-reflux operation. The catheter was removed at postoperative week one. The mean postoperative hospital stay was 2.4 days (range 1-4 days), and the mean follow-up was 9.8 months. None of the patients had postoperative ureteral obstructions, and there were no cases of migration or dislodgement of the catheter.
Our new method for removing the ureteral catheter would shorten hospital stays and lower levels of anxiety when removing ureteral catheters in patients with a high risk of postoperative ureteral obstruction.
我们回顾了在接受复杂输尿管再植术的患者中使用新型、易于移除的输尿管导管的经验。我们的目标是缩短住院时间并降低拔管时的焦虑程度,同时避免对术后输尿管梗阻的担忧。
2009 年 4 月至 2010 年 9 月,我们对 9 例接受输尿管再植术后新型导管移除方法的患者进行了研究。研究排除了接受单纯输尿管再植术的患者。输尿管再植术后,安装了一个由耻骨上膀胱造瘘管和输尿管导管组成的联合引流系统。近端外部管道用 Hem-o-lok 夹夹住,其余外部管道被去除。记录了每位患者的年龄、性别、手术原因、输尿管再植术方法以及术后参数,如住院时间和并发症等。
9 例患者中,4 例为反流性巨输尿管,4 例为孤立或无功能对侧肾脏,1 例因先前的抗反流手术而出现输尿管狭窄。术后 1 周拔除导管。术后平均住院时间为 2.4 天(范围 1-4 天),平均随访时间为 9.8 个月。所有患者均无术后输尿管梗阻,也无导管迁移或脱落的情况。
对于有术后输尿管梗阻高风险的患者,我们新的输尿管导管移除方法可缩短住院时间并降低拔管时的焦虑程度。