Zaidi Z, Mouriquand P D
Department of Urology, Great Ormond Street Hospital for Children, London, UK.
Br J Urol. 1997 Nov;80(5):802-5. doi: 10.1046/j.1464-410x.1997.00448.x.
To assess the use of a multipurpose stent (the 'Blue stent', Angiomed Urosoft Pyeloplasty Stent, Bard, UK) in children undergoing pyeloplasty and ureteric reimplantation.
Between August 1994 and August 1996, the Blue stent was used in 50 renal units in 46 children aged 2 months to 12 years and 6 months. Twenty-five children underwent pyeloplasty, 11 had ureteric reimplantation for vesico-ureteric reflux (VUR), eight had ureteric reimplantation with remodelling for obstructed megaureters and in two patients it was used during the removal of stones. The mean follow-up was 18 months (range 6-30 months).
After pyeloplasty, 22 patients (88%) had improved renal function and drainage with a decrease in hydronephrosis; two patients had a decrease in hydronephrosis only, one had an anastomotic leak and needed a repeat pyeloplasty and four developed a urinary tract infection (UTI). After ureteric reimplantation, VUR was not detected in any patient. Two patients had no change in drainage after remodelling and reimplantation of a megaureter, one was later diagnosed as having a neuropathic bladder and one child developed a UTI after ureteric reimplantation. The hospital stay was 3 days after pyeloplasty and 5 days after reimplantation.
The design of the multipurpose Blue stent provides versatility; it can be used as a stent, and both an internal and external drain. Its use does not prolong the hospital stay. Insertion causes minimal trauma to the renal parenchyma, and removal is easy, pain-free and requires no anaesthesia. The complication rates in the present series compare favourably with other reported series.
评估一种多用途支架(“蓝色支架”,Angiomed Urosoft肾盂成形术支架,英国巴德公司)在接受肾盂成形术和输尿管再植术的儿童中的应用情况。
1994年8月至1996年8月期间,46例年龄在2个月至12岁6个月的儿童的50个肾单位使用了蓝色支架。25例儿童接受了肾盂成形术,11例因膀胱输尿管反流(VUR)接受输尿管再植术,8例因梗阻性巨输尿管进行了输尿管再植并重塑,2例患者在取石过程中使用了该支架。平均随访时间为18个月(范围6 - 30个月)。
肾盂成形术后,22例患者(88%)肾功能和引流改善,肾积水减轻;2例患者仅肾积水减轻,1例发生吻合口漏,需要再次进行肾盂成形术,4例发生尿路感染(UTI)。输尿管再植术后,未发现任何患者存在VUR。2例患者在巨输尿管重塑和再植术后引流无变化,1例后来被诊断为神经源性膀胱,1例儿童在输尿管再植术后发生UTI。肾盂成形术后住院时间为3天,再植术后为5天。
多用途蓝色支架的设计具有多功能性;它可作为支架使用,也可作为内引流和外引流。其使用不会延长住院时间。插入对肾实质造成的创伤最小,取出容易、无痛且无需麻醉。本系列中的并发症发生率与其他报道的系列相比具有优势。