Department of Surgery, Radboud University Medical Center Nijmegen, the Netherlands; Department of Urology, Radboud University Medical Center Nijmegen, the Netherlands.
Department of Urology, Radboud University Medical Center Nijmegen, the Netherlands.
Int J Surg. 2019 Nov;71:175-181. doi: 10.1016/j.ijsu.2019.09.031. Epub 2019 Oct 7.
Routine intraoperative ureteric stenting lowers the rate of urological complications after kidney transplantation. However, there is no consensus about the optimal stent design and duration. The aim of this prospective cohort study was to compare the influence of double J (JJ) stents and externally draining percutaneous (PC) stents on the early quality of recovery after living donor kidney transplantation.
A prospective cohort study was performed in two consecutive cohorts of 40 patients who underwent living donor kidney transplantation at the Radboud university medical center between April 2016 and October 2017. The first cohort of 40 patients received a 6-French externally draining PC stent. The second cohort of 40 patients received a 6-French/14 cm JJ stent. We compared the influence of the stent design on the quality of early post-operative recovery (measured by the Quality of Recovery-40 questionnaire) and the length of hospital stay.
Patients with a JJ stent scored significantly better on the Quality of Recovery score on the third and fifth postoperative day, when compared to patients with a PC stent. Furthermore, in comparison to patients with a PC stent, patients with a JJ stent were earlier mobilising and independent in daily activities, resulting in a shorter length of hospital stay. The number of postoperative urological complications was comparable between the two groups.
The use of JJ stents during living donor kidney transplantations improves the postoperative recovery and shortens the length of hospital stay, when compared to PC stents without compromising the number of postoperative urological complications.
常规术中输尿管支架置入可降低肾移植后泌尿系统并发症的发生率。然而，对于最佳支架设计和留置时间尚未达成共识。本前瞻性队列研究旨在比较双 J（JJ）支架和经皮外引流（PC）支架对活体供肾移植后早期恢复质量的影响。
本前瞻性队列研究连续纳入了 2016 年 4 月至 2017 年 10 月在拉德堡德大学医学中心接受活体供肾移植的 40 例患者，共分为两组。第一组 40 例患者接受 6Fr 经皮外引流 PC 支架，第二组 40 例患者接受 6Fr/14cm JJ 支架。我们比较了支架设计对早期术后恢复质量（采用 40 项恢复质量问卷进行评估）和住院时间的影响。
与接受 PC 支架的患者相比，接受 JJ 支架的患者在术后第 3 天和第 5 天的恢复质量评分明显更高。此外，与接受 PC 支架的患者相比，接受 JJ 支架的患者更早地进行活动且能够自理日常活动，从而缩短了住院时间。两组术后泌尿系统并发症的数量相当。
与 PC 支架相比，活体供肾移植中使用 JJ 支架可改善术后恢复并缩短住院时间，而不会增加术后泌尿系统并发症的数量。
