Goodstein Taylor, Mershon Patrick, Posid Tasha, Khuhro Aliza, Charleton Mary, Ndumele Amara, Kleinguetl Colin, Arnold Chase, Knudsen Bodo, Sourial Michael
Department of Urology, Ohio State University Medical Center, Columbus, OH , United States.
Ohio State University College of Medicine, Columbus, OH , United States.
Can Urol Assoc J. 2023 Nov;17(11):E381-E387. doi: 10.5489/cuaj.8364.
Options for renal drainage after percutaneous nephrolithotomy (PCNL) vary and depend primarily on surgeon preference and case considerations. In our practice, patients traditionally returned one week postoperatively to remove the stents in the office via cystoscopy; however, following uncomplicated PCNL with no plans for second-look procedure, a ureteral stent on a tether is currently removed in tandem with the Foley catheter on postoperative day 1 (POD1) prior to patient discharge. This study compared the number of postoperative events between POD1 stent removal and their longer stented counterparts.
We conducted a retrospective chart review on all patients who had undergone PCNL at our institution from January 1, 2020, to June 31, 2021. Patient demographics, operative metrics, and postoperative events (telephone calls, emergency department [ED ]/clinic visits, and complications) were recorded and compared between the two groups.
A total of 243 patients were included in final analysis: 46% (n=111) had their stent removed on POD1 and 54% (n=132) had longer indwelling stent times. Baseline demographics were similar between the two groups. Number of telephone calls (p=0.081), ED /clinic visits (p=0.093), and complications (p=0.647) were similar between groups. There were three (1.3%) unplanned second-look procedures: two (1.8%) in the POD1 stent removal group and one (0.8%, p=0.475) in the later stent removal group.
In this limited, retrospective study, we did not detect a difference in postoperative events or short-term complications for POD1 vs. later stent removal after uncomplicated PCNL.
经皮肾镜取石术（PCNL）后的肾脏引流方式多种多样，主要取决于外科医生的偏好和具体病例情况。在我们的临床实践中，传统上患者术后一周返回办公室，通过膀胱镜取出支架；然而，对于未进行二次探查手术计划的无并发症PCNL患者，目前在术后第1天（POD1）患者出院前，将带系绳的输尿管支架与Foley导尿管一并取出。本研究比较了POD1取出支架组和留置支架时间较长组术后事件的数量。
我们对2020年1月1日至2021年6月31日在我院接受PCNL的所有患者进行了回顾性病历审查。记录并比较两组患者的人口统计学资料、手术指标和术后事件（电话随访、急诊科[ED]/门诊就诊及并发症）。
共有243例患者纳入最终分析：46%（n = 111）在POD1取出支架，54%（n = 132）留置支架时间较长。两组的基线人口统计学资料相似。两组之间的电话随访次数（p = 0.081）、ED/门诊就诊次数（p = 0.093）和并发症发生率（p = 0.647）相似。有3例（1.3%）计划外二次探查手术：POD1取出支架组2例（1.8%），后期取出支架组1例（0.8%，p = 0.475）。
在这项有限的回顾性研究中，我们未发现无并发症PCNL后POD1取出支架与后期取出支架在术后事件或短期并发症方面存在差异。
