Bai Pei-de, Wang Tao, Huang Hai-Chao, Wu Zhun, Wang Xue-Gang, Qin Jia-Xuan, Wang Hui-Qiang, Chen Bin, Hu Meng-Bo, Xing Jin-Chun
The Key Laboratory of Urinary Tract Tumors and Calculi, Department of Urology Surgery, The First Affiliated Hospital of Xiamen University, Xiamen, 361003, China.
Department of Urology, Huashan Hospital, Fudan University, Shanghai, 200000, China.
Curr Med Sci. 2021 Feb;41(1):140-144. doi: 10.1007/s11596-021-2328-z. Epub 2021 Feb 13.
The effect of preoperative Double-J (DJ) ureteral stenting before flexible ureterorenoscopy (FURS) in the treatment for urinary stones was evaluated. We retrospectively enrolled 306 consecutive patients who underwent FURS from Jan. 2014 to Dec. 2017. All the patients were classified into two groups according to whether they had DJ ureteral stenting before FURS. Baseline characteristics (age, sex, stone location, stone size, surgical success rate, operation time, stone-free rate of the first day after surgery, stone-free rate of the first month after surgery, total complication rate) were compared using Chi-square test for categorical variables and Kruskal-Wallis test for continuous variables. In total, 306 patients were included in this study. The group of DJ stenting before FURS included 203 (66.3%) patients, and non-DJ stenting before FURS was observed in 103 (33.7%) patients. The group of DJ stenting before FURS was significantly associated with a shorter operation time (53.8 vs. 59.3 min, P<0.001), a higher stone-free rate of the first day after surgery (69.0% vs. 51.5%, P=0.003). However, statistical significant differences were not found in the age, sex, stone location, stone size, surgical success rate, stone-free rate of the first month after surgery (89.2% vs. 81.6%, P=0.065) and total complication rate (5.4% vs. 9.7%, P=0.161) between the two groups. Preoperative DJ ureteral stenting before FURS could reduce the operation time and increase stone-free rate of the first day after surgery. However, it might not benefit the stone-free rate of the first month after surgery and reduce the complication rate. Preoperative DJ stenting should be not routinely performed.
评估了术前双J（DJ）输尿管支架置入术在输尿管软镜碎石术（FURS）治疗尿路结石中的效果。我们回顾性纳入了2014年1月至2017年12月期间连续接受FURS治疗的306例患者。根据患者在FURS术前是否置入DJ输尿管支架，将所有患者分为两组。采用卡方检验对分类变量进行比较，采用Kruskal-Wallis检验对连续变量进行比较，比较两组患者的基线特征（年龄、性别、结石位置、结石大小、手术成功率、手术时间、术后第一天结石清除率、术后第一个月结石清除率、总并发症发生率）。本研究共纳入306例患者。FURS术前置入DJ支架组有203例（66.3%）患者，FURS术前未置入DJ支架组有103例（33.7%）患者。FURS术前置入DJ支架组的手术时间明显更短（53.8 vs. 59.3分钟，P<0.001），术后第一天结石清除率更高（69.0% vs. 51.5%，P=0.003）。然而，两组在年龄、性别、结石位置、结石大小、手术成功率、术后第一个月结石清除率（89.2% vs. 81.6%，P=0.065）和总并发症发生率（5.4% vs. 9.7%，P=0.161）方面未发现统计学显著差异。FURS术前置入DJ输尿管支架可缩短手术时间并提高术后第一天的结石清除率。然而，它可能对术后第一个月的结石清除率无益处，也不能降低并发症发生率。FURS术前不应常规进行DJ支架置入。
