Effect of postoperative stent placement time on the outcome of flexible ureteroscope lithotripsy in the treatment of kidney calculi
10.3760/cma.j.cn115396-20190729-00125
- VernacularTitle:术后支架置入时间对输尿管软镜碎石术治疗肾结石结局的影响分析
- Author:
Xianzhong WANG
1
;
Zhong WANG
;
Dapeng HE
;
Xisong XIE
Author Information
1. 广元市中心医院泌尿外科 628000
- From:
International Journal of Surgery
2020;47(9):619-623
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the effect of postoperative stent placement time on flexible ureteroscopy lithotripsy (FURL) in the treatment of kidney calculi.Methods:A retrospective analysis of 126 patients with kidney calculi admitted to Guangyuan Central Hospital from April 2017 to November 2018. All patients were treated with FURL. The patients were divided into two groups according to the time of stent placement after FURL: conventional tube placement group ( n=91) and short-term tube placement group ( n=35). The postoperative stent placement time of patients in the conventional tube placement group was 4 weeks, and the postoperative stent placement time of patients in the short-term tube placement group was 2 weeks. The postoperative outcome indicators (hospitalization time and stone-free rate), postoperative complication indicators (postoperative hematuria, renal hematoma, urinary tract infection and fever) and postoperative pain were compared between the two groups. The measurement data was expressed as mean±standard deviation ( Mean± SD), and the Student′s t test was used for comparison between groups; the Chi-square test was used for comparison between counting data. Results:There were not significant differences in hospitalization time [(7.22±1.02) d vs (7.26±1.22) d], stone-free rate 1 month after surgery (84.6% vs 82.8%), stone-free rate 2 month after surgery (93.4% vs 88.5%), postoperative hematuria (10.9% vs 11.4%), renal hematoma (3.3% vs 0) and fever (2.2% vs 0) between the conventional tube placement group and short-term tube placement group ( P>0.05). Compared with the conventional tube placement group, the short-term tube group had lower urinary tract infection rates (17.6% vs 2.9%), the difference was statistically significant ( P<0.05). There was not significant difference in the average use rate of opioids [(1.05±0.45) vs (1.00±0.50), P>0.05], acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) [(1.52±0.55) vs (1.45±0.45), P>0.05] between the two groups during hospitalization. There was not statistically significant difference in the incidence of abdominal pain after discharge from the hospital [(1.25±0.55) vs (1.15±0.45)]. The number of applications of acetaminophen and NSAIDs in the conventional tube placement group was greater than that in the short-term tube placement group [(1.45±0.46) vs (1.25±0.30)] after one month, the difference was statistically significant ( P<0.05). Conclusions:Short-term tube placement after renal FURL surgery is as effective as traditional long-term stenting, achieving the same stone-free effect and reducing early postoperative complications. For the reduction of postoperative infection and postoperative pain, short-term stenting has certain advantages.
