Paul Charles J, Brooks Nathan A, Ghareeb George M, Tracy Chad R
Department of Urology, The University of Iowa, Iowa City, IA, USA.
Curr Urol. 2018 Feb;11(2):97-102. doi: 10.1159/000447201. Epub 2017 Dec 30.
BACKGROUND/AIMS: Many providers elect to place a stent following ureteroscopy for nephrolithiasis, but little data exists on the optimal duration to leave a stent. We sought to determine whether there are any differences in post-operative outcomes for patients with a 3 versus 7-day stent following ureteroscopy.
We retrospectively reviewed 247 patients who underwent unilateral ureteroscopy with lithotripsy, 79 of whom removed a stent with an extraction string at 3 or 7 days post-operatively. These 2 groups were compared with regard to demographic information, pre-operative variables, and post-operative outcomes.
Of all patients, 33% experienced a post-procedure related event (phone call, extra clinic visit, and emergency department visit) within 30 days of their procedure, 39% of 3-day stent patients compared to 21% of 7-day patients (p = 0.11). Within the 3 days following stent removal, 3-day stent patients were significantly more likely to have a post-procedure related event than 7-day patients (23 vs. 3%, p = 0.026).
One third of patients with a post-operative ureteral stent will seek medical care in the 30 days following ureteroscopy. Leaving a stent for 3 versus 7 days may lead to worse outcomes with regard to post-operative events and fank pain.
背景/目的：许多医疗服务提供者在输尿管镜检查治疗肾结石后选择放置支架，但关于支架最佳留置时间的数据很少。我们试图确定输尿管镜检查后留置3天与7天支架的患者术后结果是否存在差异。
我们回顾性分析了247例行单侧输尿管镜碎石术的患者，其中79例在术后3天或7天通过取石绳取出支架。比较了这两组患者的人口统计学信息、术前变量和术后结果。
在所有患者中，33%在术后30天内经历了与手术相关的事件（电话随访、额外门诊就诊和急诊就诊），3天支架组患者为39%，7天支架组患者为21%（p = 0.11）。在取出支架后的3天内，3天支架组患者比7天支架组患者更有可能发生与手术相关的事件（23%对3%，p = 0.026）。
三分之一的术后输尿管支架患者在输尿管镜检查后的30天内会寻求医疗护理。留置3天与7天的支架在术后事件和腰痛方面可能导致更差的结果。
