Ooms Liselotte S S, Spaans Laura G, Betjes Michiel G H, Ijzermans Jan N M, Terkivatan Türkan
Department of Surgery Division of Transplant Surgery, Erasmus MC, University Medical Center Rotterdam, The Netherlands.
Exp Clin Transplant. 2017 Apr;15(2):143-149. doi: 10.6002/ect.2016.0051. Epub 2016 Aug 24.
The aim of this study was to evaluate the effects of 2 types of external ureteral stents on the number of urological complications after kidney transplant.
Data were retrospectively collected from 366 consecutive transplants performed between January 2013 and January 2015 in our hospital, in which an external ureteral stent was placed during surgery and removed after 9 days. Urological complications were defined as urinary leakage or ureteral stenosis requiring percutaneous nephrostomy placement.
A total of 197 patients received a straight stent with 2 larger side holes (type A; 8F "Covidien" tube; Covidien, Dublin, Ireland) and 169 patients received a single J stent with 7 smaller side holes (type B; 7F "Teleflex" single J stent; Teleflex Medical, Athlone, Ireland). We found a significantly higher number of percutaneous nephrostomy placements with type A stents, with 34 (17%) versus 16 (9%) in type B (P = .030). Reason for percutaneous nephrostomy placement, occurrence of stent dysfunction, and need for early removal (< 8 days) were equal in both groups (P = .397), whereas incidence of rejection and urinary tract infection were higher in type B stent group. Patient and graft survival did not differ between the groups.
Use of the type B stent was associated with less urological complications compared with the type A stent.
本研究旨在评估两种类型的输尿管外支架对肾移植术后泌尿系统并发症数量的影响。
回顾性收集2013年1月至2015年1月在我院连续进行的366例移植手术的数据，术中放置输尿管外支架并于9天后取出。泌尿系统并发症定义为尿漏或需要经皮肾造瘘的输尿管狭窄。
共有197例患者接受了带有2个较大侧孔的直支架（A型；8F“柯惠”导管；柯惠医疗，都柏林，爱尔兰），169例患者接受了带有7个较小侧孔的单J支架（B型；7F“泰利福”单J支架；泰利福医疗，阿斯隆，爱尔兰）。我们发现A型支架的经皮肾造瘘置入数量显著更高，分别为34例（17%）和B型的16例（9%）（P = 0.030）。两组经皮肾造瘘置入的原因、支架功能障碍的发生率以及早期取出（<8天）的需求相同（P = 0.397），而B型支架组的排斥反应和尿路感染发生率更高。两组患者和移植物的生存率无差异。
与A型支架相比，使用B型支架与较少的泌尿系统并发症相关。
