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单纯输尿管镜检查治疗远端输尿管结石后输尿管支架置入术:一项随机对照试验。

Ureteral stenting after uncomplicated ureteroscopy for distal ureteral stones: a randomized, controlled trial.

作者信息

El Harrech Y, Abakka N, El Anzaoui J, Ghoundale O, Touiti D

机构信息

Department of Urology, Hospital Avicenne, Marrakech 40000, Morocco.

出版信息

Minim Invasive Surg. 2014;2014:892890. doi: 10.1155/2014/892890. Epub 2014 Nov 9.

Abstract

Objectives. We compared outcome and complications after uncomplicated ureteroscopic treatment of distal ureteral calculi with or without the use of ureteral stents. Materials and Methods. 117 patients, prospectively divided into three groups to receive a double j stent (group 1, 42 patients), ureteral stent (group 2, 37 patients), or no stent (group 3, 38 patients), underwent ureteroscopic treatment of distal ureteral calculi. Stone characteristics, operative time, postoperative pain, lower urinary tract symptoms (LUTS), analgesia need, rehospitalization, stone-free rate, and late postoperative complications were all studied. Results. There were no significant differences in preoperative data. There was no significant difference between the three groups regarding hematuria, fever, flank pain, urinary tract infection, and rehospitalisation. At 48 hours and 1 week, frequency/urgency and dysuria were significantly less in the nonstented group. When comparing group 1 and group 3, patients with double j stents had statistically significantly more bladder pain (P = 0.003), frequency/urgency (P = 0.002), dysuria (P = 0.001), and need of analgesics (P = 0.001). All patients who underwent imaging postoperatively were without evidence of obstruction or ureteral stricture. Conclusions. Uncomplicated ureteroscopy for distal ureteral calculi without intraoperative ureteral dilation can safely be performed without placement of a ureteral stent.

摘要

目的。我们比较了在不使用输尿管支架和使用输尿管支架的情况下,对远端输尿管结石进行单纯输尿管镜治疗后的结果和并发症。材料与方法。117例患者被前瞻性地分为三组,分别接受双J支架(第1组,42例患者)、输尿管支架(第2组,37例患者)或不放置支架(第3组,38例患者),并接受远端输尿管结石的输尿管镜治疗。对结石特征、手术时间、术后疼痛、下尿路症状(LUTS)、镇痛需求、再次住院、结石清除率和术后晚期并发症均进行了研究。结果。术前数据无显著差异。三组在血尿、发热、胁腹疼痛、尿路感染和再次住院方面无显著差异。在48小时和1周时,未放置支架组的尿频/尿急和排尿困难明显较少。比较第1组和第3组时,放置双J支架的患者膀胱疼痛(P = 0.003)、尿频/尿急(P = 0.002)、排尿困难(P = 0.001)和镇痛需求(P = 0.001)在统计学上显著更多。所有术后接受影像学检查的患者均无梗阻或输尿管狭窄的证据。结论。对于远端输尿管结石,在不进行术中输尿管扩张的情况下,单纯输尿管镜检查可不放置输尿管支架而安全进行。

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