Comparison of nephrostomy and double-J stent in the management of percutaneous nephrolithotomy–induced renal pelvis trauma: A prospective randomized controlled trial

IF 0.3 4区 医学 Q4 SURGERY Surgical Practice Pub Date : 2023-11-27 DOI:10.1111/1744-1633.12667
Kaveh Mehravaran MD, Mohammad Kolbadinezhad MD, Robab Maghsoudi MD, Amir Hossein Kashi MD, Saeed Reza Ghanbarizadeh MD, Behzad Narouie MD, Hamidreza Rouientan MD
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引用次数: 0

Abstract

Objective

This study aimed to compare the efficacy of nephrostomy versus double-J (DJ) ureteral stent in managing kidney pelvis trauma during percutaneous nephrolithotomy (PCNL) procedures.

Methodology

This prospective parallel-group clinical trial involved 60 PCNL patients diagnosed with kidney pelvis perforation during PCNL through nephroscopy (inclusion criteria). Exclusion criteria comprised a history of previous renal surgery or prior PCNL. Eligible patients were alternately assigned to either the insertion of a nephrostomy or a ureteral DJ stent.

Results

A total of 31 patients were included in the nephrostomy group, and 29 were in the DJ group. The mean ± SD of operation duration in nephrostomy and DJ groups were 50.8 ± 23.7 and 45.7 ± 19.3 min, respectively (P = .17). Two-access PCNLs were performed in 13% and 18% of PCNL operations in the nephrostomy and DJ groups, respectively (P = .72). In the nephrostomy group, 5 patients (17%) had urinoma collection around the kidney, compared with 11 (39%) in the DJ group, showing a statistically significant difference between the two groups (P = .036). Post-operative fever and urinary leakage were observed in 48% and 32% of patients in nephrostomy group versus 44% and 22% of patients in group DJ (P = .76 and P = .39).

Conclusion

The findings of this study indicate a higher percentage of urinoma detected one week after the insertion of a ureteral DJ compared with nephrostomy in PCNL patients who experienced renal pelvis injury during the operation.

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比较肾造瘘术和双j支架治疗经皮肾镜碎石术引起的肾盂创伤:前瞻性随机对照试验研究
本研究旨在比较肾造瘘术与双J(Dj)输尿管支架在经皮肾镜碎石术(PCNL)肾盂创伤治疗中的疗效。这项前瞻性平行分组临床试验的对象是60例PCNL患者,这些患者在PCNL过程中经肾镜诊断为肾盂穿孔(纳入标准),排除标准为既往接受过肾脏手术和既往接受过PCNL。符合条件的患者被分为插入肾造口术和插入输尿管Dj支架两组。N组和Dj组手术时间的平均值(±SD)分别为50.8±23.7和45.7±19.3(P=0.17)。在 N 组和 Dj 组的 PCNL 手术中,分别有 13% 和 18% 进行了两次入路 PCNL(P = 0.72)。N 组有 5 名患者(17%)在肾脏周围出现尿瘤聚集,而 Dj 组有 11 名患者(39%)。N组分别有48%和32%的患者出现术后发热和漏尿,而Dj组分别有44%和22%的患者出现术后发热和漏尿,两组差异有统计学意义(P = 0.036)。本研究结果显示,与肾造瘘术相比,PCNL 患者在插入输尿管 Dj 一周后发现尿瘤的比例更高,因为这些患者在手术过程中肾盂受伤。"本研究已在伊朗临床试验登记处登记,代码为 IRCT20191230045956N1。"
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来源期刊
Surgical Practice
Surgical Practice 医学-外科
CiteScore
0.90
自引率
0.00%
发文量
74
审稿时长
>12 weeks
期刊介绍: Surgical Practice is a peer-reviewed quarterly journal, which is dedicated to the art and science of advances in clinical practice and research in surgery. Surgical Practice publishes papers in all fields of surgery and surgery-related disciplines. It consists of sections of history, leading articles, reviews, original papers, discussion papers, education, case reports, short notes on surgical techniques and letters to the Editor.
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