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处理遗忘输尿管支架不同后果的经验

Experiences in managing different consequences of forgotten ureteral stents.

作者信息

Xie Donghua, Hu Chenbo, Gu Di, Cai Cong, Liu Yongda, Zeng Guohua, Lei Ming

机构信息

Department of Urology, Minimally Invasive Surgery Center, Guangdong Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.

出版信息

Urol Ann. 2022 Apr-Jun;14(2):141-146. doi: 10.4103/UA.UA_165_20. Epub 2022 Feb 15.

Abstract

PURPOSE

We reported the different consequences of forgotten stents and share our managing experiences.

PATIENTS AND METHODS

From July 2011 to August 2019, eight patients (five men and three women) with forgotten encrusted ureteral stents were treated by different endoscopic procedures in our center. Plain-film radiography (kidney, ureter, and bladder [KUB]) and computed tomography were used to evaluate the position of stents, the site of encrustation, and the stone burden. Various sole or combined endoscopic techniques including percutaneous nephrolithotomy, retrograde ureteroscopic lithotripsy, and cystolitholapaxy were used to achieve stent removal.

RESULTS

The average age of the patients was 50.9 years (range: 25-72 years). The mean indwelling time of the stents was 32.9 months (range: 12-83 months). Mean stent stone burden was 15 mm × 10 mm. Three patients had stent stone burden larger than 20 mm. Three patients had a preoperative positive urine culture before treatment. The stent was fragmented in two patients. The ureteral stents and related stones were successfully removed without any complications by a sole or combined endoscopic techniques with stone-free status achieved in all patients. There is no complications occurred.

CONCLUSION

Forgotten stents can lead to complicated urinary tract calculi, stent encrustation, urinary tract infection, vesicoureteric reflux, and even ureteral polyps. Various sole or combined endourological techniques can be used to manage the forgotten encrusted ureteral stents.

摘要

目的

我们报告了遗忘输尿管支架的不同后果,并分享我们的处理经验。

患者与方法

2011年7月至2019年8月,我们中心对8例(5例男性,3例女性)遗忘的输尿管结壳支架患者采用不同的内镜手术进行治疗。通过腹部平片(肾脏、输尿管和膀胱[KUB])及计算机断层扫描评估支架位置、结壳部位及结石负荷。采用包括经皮肾镜取石术、逆行输尿管镜碎石术及膀胱碎石术等各种单一或联合的内镜技术来取出支架。

结果

患者的平均年龄为50.9岁(范围:25 - 72岁)。支架的平均留置时间为32.9个月(范围:12 - 83个月)。支架结石平均大小为15 mm×10 mm。3例患者的支架结石负荷大于20 mm。3例患者在治疗前尿培养呈阳性。2例患者的支架发生断裂。通过单一或联合内镜技术成功取出输尿管支架及相关结石,所有患者均达到无结石状态,且未发生任何并发症。

结论

遗忘输尿管支架可导致复杂的尿路结石、支架结壳、尿路感染、膀胱输尿管反流,甚至输尿管息肉。各种单一或联合的腔内泌尿外科技术可用于处理遗忘的输尿管结壳支架。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/af4d/9197003/0b4fe6919f13/UA-14-141-g001.jpg

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