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Stent Removal in 200 Kidney Transplant Recipients: Nonoperative Versus Endoscopic Removal

机译:200名肾脏移植受者的支架切除:非手术对内镜切除

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Objectives: Inserting a double J stent during kidney transplant has reduced the rate of urologic com-plications. Traditionally, a double J stent is removed via endoscopic intervention. Here, we assessed the safety and efficacy of a nonoperative method for double J stent removal. Materials and Methods: Our study group included 200 consecutive patients who underwent kidney transplant from January 2013 to April 2014. Group A consisted of 100 recipients who had a double J stent that was tied to a Foley catheter with 2-0 silk suture. The stent was simply removed by taking out the Foley catheter after 3 weeks. Patients in group A were compared with a second group of 100 kidney transplant patients whose stents were removed endoscopically 3 weeks later (group B). Results: Patients were matched between the 2 groups regarding age distribution, male-to-female patient ratio, deceased versus living donor graft, prevalence of type 2 diabetes mellitus, and body mass index. The incidence of urinary fistula (3% in group A and 4% in group B; P = .7), ureteral stenosis (1% in group A and 2% in group B; P = .56), wound infection (1% in group A and 2% in group B; P = .56), and positive urine culture (20% in group A and 29% in group B; P = .14) after stent removal were not significantly different between the 2 groups. Conclusions: This study shows that nonoperative removal of a double J stent is a safe and effective method. This approach is simple, and there is no need for a surgical procedure or any outpatient surgical intervention.
机译:目的:在肾脏移植过程中插入双J支架降低了泌尿外科并发症的发生率。传统上,双J支架是通过内窥镜干预移除的。在这里,我们评估了双J支架非手术方法的安全性和有效性。材料和方法:我们的研究组包括从2013年1月至2014年4月连续接受肾脏移植的200例患者。A组由100位接受者组成,他们的双J支架与2-0丝线缝合的Foley导管相连。 3周后通过取出Foley导管简单地除去支架。将A组患者与第二组100例肾脏移植患者进行比较,第二例患者在3周后内窥镜移除了支架(B组)。结果:两组患者在年龄分布,男女比例,已死与活体供体移植物,2型糖尿病患病率和体重指数方面处于匹配状态。尿瘘的发生率(A组为3%,B组为4%; P = .7),输尿管狭窄(A组为1%,B组为2%; P = .56),伤口感染(1%) A组中B组为2%,B组为2%; P = .56),而支架清除后尿培养阳性(A组为20%,B组为29%; P = .14)在两组之间无显着差异。结论:这项研究表明非手术切除双J支架是一种安全有效的方法。这种方法很简单,不需要手术程序或任何门诊手术干预。

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