Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China.
Department of Urology, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi, China.
Urol Int. 2021;105(7-8):594-599. doi: 10.1159/000512056. Epub 2021 Mar 19.
To initially evaluate the outcomes of the modified triangular prismatic double-J (DJ) stent in the management of 2- to 3-cm renal stones after one-stage retrograde intrarenal surgery (RIRS).
Patients with 2- to 3-cm renal stones who underwent one-stage RIRS with indwelling DJ stents were retrospectively evaluated. Eighty-eight patients who were placed the triangular prismatic DJ stents and 64 patients who received standard DJ stents were randomly included. The clinical characteristics and intraoperative and postoperative outcomes of the 2 groups were compared and analyzed.
The 2 groups had similar baseline characteristics. The urinary symptom score and pain score did not differ between groups (p > 0.05). The residual fragments of the 2 groups were similar 1 day after operation (p = 0.134). There was no significant difference in residual fragments in the lower calyx between groups at the time of stent removal (p = 0.834). The patients in the modified group had better spontaneous passage of residual fragments in the nonlower calyx than those in the standard group during the 2 weeks with the stents (p = 0.005). Fewer patients in the modified group had residual fragments (>4 mm) in the nonlower calyx (p = 0.026) and ureter (p = 0.010) than the patients with standard stents at the time of stent removal.
The indwelling triangular prismatic DJ stent is a safe and efficient treatment method. Patients with these stents had better spontaneous residual fragment passage than those with the standard DJ stents.
初步评估改良三角棱柱形双 J（DJ）支架在一期逆行肾内手术（RIRS）后治疗 2-3cm 肾结石的结果。
回顾性评估接受一期 RIRS 并留置 DJ 支架的 2-3cm 肾结石患者。随机纳入 88 例接受三角棱柱形 DJ 支架和 64 例接受标准 DJ 支架的患者。比较并分析两组患者的临床特征、手术期和术后结果。
两组患者的基线特征相似。两组的尿症状评分和疼痛评分无差异（p＞0.05）。术后 1 天两组的残石碎片相似（p=0.134）。在支架取出时，两组下盏的残石碎片无显著差异（p=0.834）。在支架置入的 2 周内，改良组患者的非下盏残石碎片自发排出情况优于标准组（p=0.005）。在支架取出时，改良组患者的非下盏（p=0.026）和输尿管（p=0.010）的残石碎片（＞4mm）少于标准支架组。
留置三角棱柱形 DJ 支架是一种安全有效的治疗方法。使用这些支架的患者自发排出残石碎片的情况优于使用标准 DJ 支架的患者。
