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经腹腔镜肾盂成形术后使用双 J 输尿管支架治疗积水型肾盂输尿管连接部梗阻:单中心经验。

Use of double-J ureteric stents post-laparoscopic pyeloplasty to treat ureteropelvic junction obstruction in hydronephrosis for pediatric patients: a single-center experience.

机构信息

Department of Urology, Children's Hospital of Nanjing Medical University, Nanjing, China.

Department of Nephrology, Children's Hospital of Nanjing Medical University, Nanjing, China.

出版信息

J Int Med Res. 2020 Apr;48(4):300060520918781. doi: 10.1177/0300060520918781.

Abstract

OBJECTIVES

We aimed to investigate the safety concerns associated with placing double-J ureteric stents post-laparoscopic pyeloplasty surgery for congenital ureteropelvic junction obstruction (UPJO) and hydronephrosis.

METHODS

A total of 1349 patients with postoperative double-J stent placement at our center were included. Clinical variables for enrolled patients were collected by two independent authors. We compared clinical variables and the efficacy of stenting post-laparoscopic pyeloplasty.

RESULTS

The mean age of the patients was 4.23 ± 2.39 years. A total of 58.49% of patients were diagnosed with left UPJO with hydronephrosis and 33.95% were diagnosed with right UPJO. Furthermore, 7.56% of patients had bilateral UPJO. In all cases, 96.96% of indwelling double-J stents were successfully removed 4 weeks post-surgery. A total of 3.04% of the patients still required further management, including stent migration to the renal pelvis (0.37%), stent migration to the bladder (0.30%), prolapse of the stent through the ureter (0.15%), blockage of stents (1.85%), and fouling of stents (0.37%).

CONCLUSIONS

Double-J ureteric stents used after laparoscopic pyeloplasty for treating UPJO in hydronephrosis for pediatric patients is a safe, feasible, and beneficial method, which can be recommended for routine procedures. However, caution should be practiced for follow-up and removal using this method.

摘要

目的

本研究旨在探讨腹腔镜肾盂成形术后留置双 J 输尿管支架治疗先天性肾盂输尿管连接部梗阻(UPJO)伴肾积水的安全性问题。

方法

回顾性分析 2012 年 1 月至 2019 年 1 月在我院接受腹腔镜肾盂成形术后留置双 J 输尿管支架的 1349 例患者的临床资料。由 2 位独立作者收集患者的临床变量。比较了不同患者的临床变量及支架留置效果。

结果

患者平均年龄为 4.23±2.39 岁。左侧 UPJO 伴肾积水 58.49%,右侧 UPJO 伴肾积水 33.95%,双侧 UPJO 7.56%。所有患者术后 4 周均成功拔除 96.96%的留置双 J 支架。3.04%的患者需要进一步处理,包括支架迁移至肾盂(0.37%)、支架迁移至膀胱(0.30%)、支架输尿管内脱垂(0.15%)、支架堵塞(1.85%)和支架污染(0.37%)。

结论

腹腔镜肾盂成形术后治疗儿童 UPJO 伴肾积水患者留置双 J 输尿管支架是一种安全、可行且有益的方法,可推荐作为常规手术。但应注意采用该方法进行随访和取出。

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