Comparison of Percutaneous Nephrostomy and Ureteral DJ Stent in Patients with Obstructive Pyelonephritis: A Retrospective Cohort Study.

IF 2.1 4区 医学 Q2 SURGERY Journal of Investigative Surgery Pub Date : 2022-07-01 DOI:10.1080/08941939.2022.2062496
Hakan Anıl, Nevzat Can Şener, Kaan Karamık, İbrahim Erol, Ediz Vuruşkan, Hakan Erçil, Zafer Gökhan Gürbüz
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引用次数: 2

Abstract

Purpose: Comparing the two different drainage methods of percutaneous nephrostomy (PCN) versus retrograde ureteral double - J (DJ) stent insertion in patients with obstructive pyelonephritis cases.

Material and methods: In this retrospective study, patients with obstructive pyelonephritis secondary to urolithiasis who underwent PCN or DJ insertion were included in the study. Patients were divided into two groups according to drainage method. After exclusion criteria, the study included 105 patients. The groups were compared for intraoperative outcomes, duration of fluoroscopy usage, the time needed for normalization of infection parameters (white blood cells (WBC), C - reactive protein (CRP), procalcitonin), and complications were observed.

Results: From 105 patients, 56 patients were in DJ stent group and 49 patients were in PCN group. According to intraoperative data, operative time and fluoroscopy duration were significantly shorter in the DJ ureteral stent group (P < .001). WBC returned to normal range in mean 3.5 ± 1.3 days in the DJ stent group and 3.2 ± 1.1 days in the PCN group (95% CI: -0.76-0.21, P = .268). There were no statistically significant differences identified for the duration for CRP, PCT and fever to return to normal range between the drainage methods. The complication rates was 51.8% for DJ stent group and, 30.6% in PCN group (P = .028).

Conclusion: Both methods are effective and safe in obstructive pyelonephritis. Despite the higher complication rate in DJ stent group, these complications were minor.

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经皮肾造口术与输尿管DJ支架治疗梗阻性肾盂肾炎的比较:回顾性队列研究。
目的:比较经皮肾造口术(PCN)与逆行输尿管双J型(DJ)支架置入术两种引流方式在梗阻性肾盂肾炎患者中的应用。材料和方法:本回顾性研究纳入了行PCN或DJ插入的继发于尿石症的梗阻性肾盂肾炎患者。根据引流方式将患者分为两组。根据排除标准,研究纳入105例患者。比较两组术中结果、透视时间、感染参数(白细胞(WBC)、C反应蛋白(CRP)、降钙素原)正常化所需时间,并观察并发症。结果:105例患者中,DJ支架组56例,PCN支架组49例。术中资料显示,DJ输尿管支架组手术时间和透视时间均明显缩短(P < 0.001)。DJ组WBC恢复正常平均时间为3.5±1.3天,PCN组平均时间为3.2±1.1天(95% CI: -0.76 ~ 0.21, P = 0.268)。两种引流方法的CRP、PCT及发热恢复正常所需时间差异无统计学意义。DJ组和PCN组并发症发生率分别为51.8%和30.6% (P = 0.028)。结论:两种方法治疗梗阻性肾盂肾炎安全有效。尽管DJ支架组并发症发生率较高,但这些并发症较少。
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来源期刊
CiteScore
4.20
自引率
0.00%
发文量
114
审稿时长
6-12 weeks
期刊介绍: Journal of Investigative Surgery publishes peer-reviewed scientific articles for the advancement of surgery, to the ultimate benefit of patient care and rehabilitation. It is the only journal that encompasses the individual and collaborative efforts of scientists in human and veterinary medicine, dentistry, basic and applied sciences, engineering, and law and ethics. The journal is dedicated to the publication of outstanding articles of interest to the surgical research community.
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