Servicio de Urología, Hospital General Universitario Gregorio Maranon, Madrid, Spain.
Servicio de Urología, Hospital General Universitario Gregorio Maranon, Madrid, Spain.
Actas Urol Esp (Engl Ed). 2022 May;46(4):252-258. doi: 10.1016/j.acuroe.2021.11.002. Epub 2022 May 5.
Complications arising from ureterovesical anastomosis in kidney transplantation have an important influence on the success of the procedure. The most serious and frequent complications are fistula and stenosis of the ureterovesical junction. The placement of double J stents in anastomosis is currently recommended to reduce these complications.
The aim of the study is to evaluate whether the placement of a DJ stent affects complications of anastomosis.
Retrospective analysis of 697 patients treated with cadaveric donor renal transplant in our center from 1999 to 2018 was performed. Results were compared according to double J stent placement and the surgical technique employed for anastomosis.
Transplantation was performed without DJ placement in 51.7% of the patients, compared to 48.3% who were treated with DJ stent placement. The most commonly used technique was Lich-Gregoir. Ureterovesical fistula occurred in 5% of cases, and ureterovesical stenosis in 4.2%. DJ stent behaved as a protective factor for ureterovesical fistula but did not significantly influence the development of stenosis. The Taguchi technique greatly increased the risk of developing both ureterovesical fistula and stenosis. The incidence of stenosis and fistula was significantly higher when the Taguchi technique was combined with no DJ stent placement.
DJ stent placement acts as a protective factor for ureterovesical stenosis complications. The results of our study seem to agree with current literature.
肾移植中输尿管-膀胱吻合口并发症对手术成功有重要影响。最严重和常见的并发症是输尿管-膀胱吻合口瘘和狭窄。目前推荐在吻合术中放置双 J 支架以减少这些并发症。
本研究旨在评估 DJ 支架的放置是否会影响吻合口的并发症。
对 1999 年至 2018 年在我中心接受尸体供肾移植的 697 例患者进行回顾性分析。根据双 J 支架的放置和吻合术所采用的手术技术对结果进行比较。
51.7%的患者未放置 DJ 支架,48.3%的患者放置 DJ 支架。最常用的技术是 Lich-Gregoir 技术。吻合口瘘发生率为 5%,吻合口狭窄发生率为 4.2%。DJ 支架是输尿管-膀胱瘘的保护因素,但对狭窄的发展没有显著影响。Taguchi 技术大大增加了发生输尿管-膀胱瘘和狭窄的风险。当 Taguchi 技术与不放置 DJ 支架联合应用时,狭窄和瘘的发生率显著升高。
DJ 支架的放置是输尿管-膀胱狭窄并发症的保护因素。本研究结果似乎与现有文献一致。