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新加坡亚洲患者尿路结石管理中单猪尾缝线支架非随机审计的结果

Outcomes of a non-randomised audit of single pigtail suture stents in urolithiasis management of Asian patients in Singapore.

作者信息

Lim Ee Jean, Choo Zhen Wei, Mangat Reshma, Durai Pradeep, Biligere Sarvajit, Tan Yiquan, Yeung Marcus Loh Hin, Seet Li Ting Nicole Andrea, Heng Chin Tiong, Ferreti Stefania, Gauhar Vineet

机构信息

Urology Department, Singapore General Hospital, Singapore.

Urology Department, Tan Tock Seng Hospital, Singapore.

出版信息

Asian J Urol. 2024 Apr;11(2):324-330. doi: 10.1016/j.ajur.2022.03.013. Epub 2022 Oct 1.

Abstract

OBJECTIVE

Double-J (DJ) ureteric stents are commonly placed perioperatively for semirigid or flexible ureteroscopic renal surgery. It is believed that lesser stent material within the bladder mitigates stent-related symptoms. This study aimed to evaluate the J-Fil ureteral stent, a single pigtail suture stent compared with conventional DJ stent in relation to stent symptoms in an Asian population undergoing ureterorenal intervention.

METHODS

Based on internal audit committee recommendation approval, the records of 50 patients retrieved, available data of 41 patients who were prospectively enrolled into two groups (Group 1 [J-Fil stent group], =21 and Group 2 [DJ stent group], =20) between August 2020 to January 2021, were analysed. Parameters compared were nature of procedure, stone location and size, ease of deployment or removal, and complications. A modified universal stent symptom questionnaire was used to assess morbidity of stent symptoms within 48 h of insertion and at removal.

RESULTS

Both groups had similar median age, distribution in male to female ratio, and stone size. The overall median universal stent symptom questionnaire score at insertion was similar for bladder pain, flank or loin pain, and quality of life between Group 1 and 2; however, at removal Group 1 fared significantly better than Group 2, especially for flank or loin pain and pain at voiding. Both groups had similar ease in insertion with no hospital readmissions.

CONCLUSION

Our audit favoured the single pigtail suture stent in Asian ureters in mitigating stent-related issues. It showed a good safety profile with easy deployment and removal. It promises a new standard in stenting.

摘要

目的

双J(DJ)输尿管支架常用于半硬性或软性输尿管镜肾脏手术的围手术期。人们认为,膀胱内较少的支架材料可减轻与支架相关的症状。本研究旨在评估J-Fil输尿管支架,一种单猪尾缝合支架,与传统DJ支架相比,在接受输尿管肾干预的亚洲人群中与支架症状的关系。

方法

根据内部审计委员会的建议批准,检索了50例患者的记录,分析了2020年8月至2021年1月期间前瞻性纳入两组(第1组[J-Fil支架组],=21;第2组[DJ支架组],=20)的41例患者的可用数据。比较的参数包括手术性质、结石位置和大小、放置或取出的难易程度以及并发症。使用改良的通用支架症状问卷评估插入后48小时内和取出时支架症状的发病率。

结果

两组的年龄中位数、男女比例分布和结石大小相似。第1组和第2组在插入时膀胱疼痛、胁腹或腰部疼痛以及生活质量方面的总体通用支架症状问卷中位数得分相似;然而,在取出时,第1组的情况明显优于第2组,尤其是在胁腹或腰部疼痛以及排尿疼痛方面。两组插入时的难易程度相似,均无再次入院情况。

结论

我们的审计结果表明,单猪尾缝合支架在减轻亚洲输尿管患者与支架相关的问题方面更具优势。它具有良好的安全性,放置和取出都很容易。它有望成为支架置入的新标准。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a75/11053326/b7429a97464b/gr1.jpg

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