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经尿道输尿管支架置入术联合磁性取石术:传统方法的替代选择。

Ureteric stenting with magnetic retrieval: an alternative to traditional methods.

机构信息

Department of Urology, James Connolly Memorial Hospital, Blanchardstown, Dublin 15, Ireland.

Department of Urology, Beaumont Hospital, Dublin, Ireland.

出版信息

Ir J Med Sci. 2020 Feb;189(1):289-293. doi: 10.1007/s11845-019-02075-8. Epub 2019 Aug 15.

Abstract

INTRODUCTION

Ureteric stents are frequently placed following endo-urological procedures. These stents cause significant morbidity for patients. Standard ureteric stents are removed by flexible cystoscopy. This procedure can be unpleasant for patients and requires additional resources. A newly designed magnetic stent allows removal in an outpatient setting. The aim of our study is to compare the magnetic stent and standard ureteric stents with regard to morbidity, pain on stent removal and cost-effectiveness.

METHODS

This study was carried out across two sites between September 2016 and July 2017. In site A, a magnetic stent (Urotech, Black-Star®) is removed by magnetic retrieval device. Fifty consecutive patients completed the validated Ureteric Stent Symptom Questionnaire (USSQ) and visual analogue scale (VAS) at the time of stent removal. On site B, a soft polyurethane stent (Cook Universa) was removed by flexible cystoscopy. Fifty patients were identified retrospectively and completed questionnaires by post. Cost analysis was also performed.

RESULTS

One hundred questionnaires were included for analysis. No significant difference in stent morbidity as assessed by the USSQ was shown between both groups. Median duration of stenting was significantly shorter in the magnetic stent group (5.5 versus 21.5 days, p < 0.001). Mean pain on stent removal was significantly less with magnetic retrieval (2.9 versus 3.9, p < 0.05). Complication rates were similar in both groups. Cost analysis showed a cost saving of €203 per patient with the magnetic stent group.

CONCLUSION

Magnetic stents cause similar morbidity for patients compared with standard stents removed by flexible cystoscopy; they are associated with less pain at removal and are cost saving.

摘要

介绍

输尿管支架经常在腔内泌尿外科手术后放置。这些支架会给患者带来很大的发病率。标准输尿管支架通过软性膀胱镜取出。该程序可能会使患者感到不适,并需要额外的资源。一种新设计的磁性支架可在门诊环境中取出。我们的研究目的是比较磁性支架和标准输尿管支架在发病率、支架取出时的疼痛和成本效益方面的差异。

方法

这项研究在 2016 年 9 月至 2017 年 7 月在两个地点进行。在 A 地点,使用磁性回收装置取出磁性支架(Urotech,Black-Star®)。50 例连续患者在支架取出时完成了经过验证的输尿管支架症状问卷(USSQ)和视觉模拟量表(VAS)。在 B 地点,使用软性聚氨酯支架(Cook Universa)通过软性膀胱镜取出。通过回顾性识别 50 例患者,并通过邮寄方式完成问卷调查。还进行了成本分析。

结果

共纳入 100 份问卷进行分析。两组之间的支架发病率没有显著差异,通过 USSQ 评估。磁性支架组的中位支架留置时间明显短于对照组(5.5 天与 21.5 天,p<0.001)。磁性回收时的平均疼痛明显较轻(2.9 与 3.9,p<0.05)。两组的并发症发生率相似。成本分析显示,使用磁性支架组每位患者可节省 203 欧元。

结论

与通过软性膀胱镜取出的标准支架相比,磁性支架对患者的发病率相似;它们与较少的取出疼痛相关,并具有成本效益。

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