BACKGROUND:The aim of this study was to evaluate the role of flexible cystoscopy in preventing malpositioning of the ureteral stent after laparoscopic ureterolithotomy in male patients. METHODS:From April 2009 to June 2015, 97 male patients with stones >1.8 cm in the upper ureter underwent intracorporeal double-J stenting of the ureter after laparoscopic ureterolithotomy performed by four different surgeons. In the last 50 patients who underwent laparoscopic ureterolithotomy flexible cystoscopy was performed through the urethral route to confirm the position of the double-J stent, while in the first 47 correct positioning of the stent was confirmed through postoperative KUB. The demographic data and perioperative outcomes were reviewed retrospectively. Penalized logistic regression analysis was used to evaluate the effects of flexible cystoscopy. RESULTS:Upward malpositioning of the ureteral stent was found in 9 of the 47 (19.1%) patients who underwent surgery without flexible cystoscopy. Among the 50 most recent patients who underwent surgery with flexible cystoscopy through the urethral route, upward malpositioning was observed in 10 (20%) patients. The factors preventing upward malpositioning of the double-J catheter in multivariate analysis were surgeon (p = 0.039) and use of flexible cystoscopy (p = 0.008). CONCLUSION:Flexible cystoscopy is a simple, safe, quick, and effective method to identify and correct malpositioning of double-J stents, especially in male patients. TRIAL REGISTRATION:This study was registered with ClinicalTrials.gov Registry on May 11, 2017 (retrospective registration) with a trial registration number of NCT03150446 .

译文

摘要背景:本研究的目的是评估柔性膀胱镜在预防男性患者腹腔镜输尿管结石术后输尿管支架位置不正中的作用。
方法:2009年4月至2015年6月,由四位不同的医生进行了腹腔镜输尿管结石切除术后,对97例输尿管上段结石> 1.8 cm的男性男性患者进行了输尿管的体内双J支架置入术。在最近的50例中,通过尿道路线进行了腹腔镜输尿管结石术的柔性膀胱镜检查以确认double-J支架的位置,而在最初的47例中,通过术后KUB确认了支架的正确位置。回顾性地回顾了人口统计学数据和围手术期结局。惩罚逻辑回归分析用于评估柔性膀胱镜检查的效果。
结果:47例(19.1%)患者中,有9例(19.1%)接受了无膀胱镜检查,输尿管支架向上定位不良。在最近通过尿道经膀胱膀胱镜手术的50例患者中,有10例(20%)患者出现错位。在多因素分析中,防止双J导管向上错位的因素是外科医生(p = 0.039)和使用柔性膀胱镜检查(p = 0.008)。
结论:柔性膀胱镜检查是一种简单,安全,快速,有效的方法,可以识别和纠正双J支架的位置不正确,特别是在男性患者中。
试验注册:本研究于2017年5月11日在ClinicalTrials.gov注册中心进行了注册(回顾性注册),试验注册号为NCT03150446。

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