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用于操作和取出支架的经尿道导丝环:输尿管支架取出术中一种新颖、创新的视频内镜技术。

Transurethral guidewire loop for manipulation and extraction of stent: A novel, innovative, video-endoscopic technique in ureteral stent removal.

作者信息

Adam Ahmed, Perera Marlon

机构信息

Division of Urology, Department of Surgery, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

Department of Surgery, University of Melbourne, Melbourne, VIC, Australia.

出版信息

Curr Urol. 2025 Mar;19(2):117-124. doi: 10.1097/CU9.0000000000000170. Epub 2025 Jan 18.

Abstract

BACKGROUND

Ureteral stent removal is one of the most common procedures performed in urology. Herein, we describe a novel technique for stent removal using transurethral guidewire loop for manipulation and extraction of stents method. We aimed to evaluate the role, feasibility, cost, operative time, and complications of the method. A review of the literature outlining the innovations in ureteral stent removal was also performed.

MATERIALS AND METHODS

Cystoscopic stent removal was performed using transurethral guidewire loop for manipulation and extraction of stents in all sequential cases. Variables including sex, age, stent type, duration, reason for stent insertion, type of anesthesia (general/local), cystoscopic stent removal time, and documentation of postprocedural complications were tabulated. In addition, using the search term "novel innovation in ureteral stent removal," various databases (PubMed, EMBASE, Cochrane Library, SCOPUS, and Web of Science) were searched.

RESULTS

Transurethral guidewire loop for manipulation and extraction of stents was successfully performed in all patients assessed on the first attempt. The patients comprised both sexes. The procedure was well tolerated under local anesthesia (4 of 5 cases), whereas general anesthesia was used in 1 case as the patient was booked for subsequent ureteroscopy under the same anesthetic. The procedure time was <27 seconds in all the cases assessed. No significant complications were noted. Fifteen studies involving novel innovations were included in the critical appraisal.

CONCLUSIONS

Transurethral guidewire loop for manipulation and extraction of stents is a simple, cost-effective, and innovative alternative for removing ureteral stents. It may be easily applied instead of a conventional ureteral stent grasper. Published innovative trends in ureteral stent removal have evolved over time, including advancements in stent design, retrieval devices, and the use of fluoroscope-free and cystoscope-free techniques.

摘要

背景

输尿管支架取出术是泌尿外科最常见的手术之一。在此,我们描述一种使用经尿道导丝环操作和取出支架的新技术。我们旨在评估该方法的作用、可行性、成本、手术时间及并发症。还对概述输尿管支架取出术创新的文献进行了综述。

材料与方法

在所有连续病例中,均使用经尿道导丝环操作和取出支架进行膀胱镜下支架取出术。将性别、年龄、支架类型、留置时间、支架置入原因、麻醉类型(全身/局部)、膀胱镜下支架取出时间以及术后并发症记录等变量制成表格。此外,使用搜索词“输尿管支架取出术的新创新”,检索了各种数据库(PubMed、EMBASE、Cochrane图书馆、SCOPUS和Web of Science)。

结果

在所有首次评估的患者中,使用经尿道导丝环操作和取出支架均成功完成。患者包括男性和女性。该手术在局部麻醉下耐受性良好(5例中有4例),而有1例患者因计划在同一麻醉下进行后续输尿管镜检查而使用了全身麻醉。在所有评估的病例中,手术时间均<27秒。未观察到明显并发症。在批判性评估中纳入了15项涉及新创新的研究。

结论

使用经尿道导丝环操作和取出支架是一种简单、经济高效且创新的输尿管支架取出替代方法。它可轻松替代传统的输尿管支架抓取器应用。随着时间的推移,已公布的输尿管支架取出创新趋势不断演变,包括支架设计、取出装置以及无荧光镜和无膀胱镜技术的进展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e07/12042180/675adacaa9b9/curr-urol-19-117-g001.jpg

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