切换至 "中华医学电子期刊资源库"

中华腔镜泌尿外科杂志(电子版) ›› 2020, Vol. 14 ›› Issue (03) : 189 -191. doi: 10.3877/cma.j.issn.1674-3253.2020.03.007

所属专题: 文献

临床研究

免膀胱镜拔出输尿管支架:只多要一条快微乔线和一条丝线
曾兆慧1, 郑小青2, 延敏博2, 郑浩2, 黄书畅2, 楚溪2, 郭振宇2,()   
  1. 1. 519000 珠海,中山大学附属第五医院冠心病重症监护室
    2. 519000 珠海,中山大学附属第五医院泌尿外科
  • 收稿日期:2019-09-28 出版日期:2020-06-01
  • 通信作者: 郭振宇
  • 基金资助:
    广东省珠海市科技计划项目(20171009E030030)

Non-cystoscopic removal of retained ureteral sents: What we need is just a segment of Vicryl Rapide and a silk thread

Zhaohui Zeng1, Xiaoqing Zheng2, Minbo Yan2, Hao Zheng2, Shuchang Huang2, Xi Chu2, Zhenyu Guo2,()   

  1. 1. Department of Cardiac Center Unit, the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai 519000, China
    2. Department of Urology, the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai 519000, China
  • Received:2019-09-28 Published:2020-06-01
  • Corresponding author: Zhenyu Guo
  • About author:
    Corresponding author: Guo Zhenyu, Email:
引用本文:

曾兆慧, 郑小青, 延敏博, 郑浩, 黄书畅, 楚溪, 郭振宇. 免膀胱镜拔出输尿管支架:只多要一条快微乔线和一条丝线[J]. 中华腔镜泌尿外科杂志(电子版), 2020, 14(03): 189-191.

Zhaohui Zeng, Xiaoqing Zheng, Minbo Yan, Hao Zheng, Shuchang Huang, Xi Chu, Zhenyu Guo. Non-cystoscopic removal of retained ureteral sents: What we need is just a segment of Vicryl Rapide and a silk thread[J]. Chinese Journal of Endourology(Electronic Edition), 2020, 14(03): 189-191.

目的

介绍一种使用快微乔线和丝线制备免膀胱镜拔除的输尿管支架管的方法。

方法

距输尿管支架管远端约12 cm(女性8 cm)管壁上缝合一条5-0快微乔线,长度适宜的丝线作为牵拉线缝合在输尿管支架管的远端,牵拉线沿输尿管支架管向近端折叠,它的中点与快微乔线打结固定,远端为自由端。快微乔线降解后解除了对牵拉线的固定,牵拉线顺着尿流出现在尿道外口,通过牵拉丝线就可以拔除输尿管支架管。

结果

研究纳入了40例患者,制备输尿管支架管的平均耗时为(2.03±0.29)min,39例(95%)牵拉线出现在尿道外口,平均时间为术后(18±3,15~21)d。拔除过程中疼痛视觉模拟评分为(0.82±0.34,0~3)。

结论

这种输尿管支架管可以避免膀胱镜拔除,成功率高而成本更低。

Objective

To simply remove retained ureteral stents, we present a novel procedure in reforming the stents which can be draw out without cystoscope by using a Vicryl Rapide and a silk thread.

Method

One end of a silk stitch is sutured at the distal end of the ureteral stent and another end is free. The silk stitch is fold up along the ureteral stent and tied with the Vicryl Rapid at the lower part of the ureteral stent. After the Vicryl Rapide degraded, the free end of the silk stitch is released and appeared with the urinary stream in the urethra. Retained ureteral stent is removed just by pulling the silk stitch. Forty patients were enrolled in our research, and all the ureteral stents were placed with the novel procedure.

Result

The mean operation time for preparing the ureteral stent was (2.03±0.29) mins, and the mean time of silk stitch from operation to being visible at the urethral meatus was (18.3±3, 15-21) days. Thirty-nine(95%) of retained ureteral stents were successfully draw out by urologist or patients themselves without any surgical instruments.

Conclusion

This new non-cystoscopic removal procedure we have established has less operation time, high success rate and costs less.

图3 徒手牵拉丝线拔除输尿管支架管,白色箭头为残留的快微乔线
[1]
Uthappa M, Cowan N. Retrograde or antegrade double-pigtail stent placement for malignant ureteric obstruction? [J] Clin Radiol, 2005, 60(5): 608-612.
[2]
Kim JH, Park SY, Kim MG, et al. Pain and satisfaction during rigid cystoscopic ureteral stent removal: a preliminary study[J]. BMC Urol, 2014, 14(1): 90.
[3]
Barros AA, Oliveira C, Ribeiro AJ, et al. In vivo assessment of a novel biodegradable ureteral stent[J]. World J Urol, 2018, 36(2): 277-283.
[4]
Althaus AB, Li K, Pattison E, et al. Rate of dislodgment of ureteral stents when using an extraction string after endoscopic urological surgery[J]. J Urol, 2015, 193(6): 2011-2014.
[5]
周鹤同, 沈华, 林建中, 等.输尿管支架管移位的原因分析及对策[J/CD]. 中华腔镜泌尿外科杂志(电子版), 2010, 4(03): 190-192.
[6]
Siegel A, Altadonna V, Ellis D, et al. Simplified method of indwelling ureteral stent removal[J]. J Urol, 1986, 28(5): 429.
[7]
Dong J, Lu J, Zu Q, et al. Routine short-term ureteral stent in living donor renal transplantation: introduction of a simple stent removal technique without using anesthesia and cystoscope[J]. Transplant Proc, 2011, 43(10): 3747-3750.
[8]
McCaul LK, Bagg J, Jenkins WM. Rate of loss of irradiated polyglactin 910 (Vicryl Rapide) from the mouth: a prospective study[J]. Br J Oral Maxillofac Surg, 2000, 38(4): 328-330.
[1] 曹钰彬, 潘剑. 阻生牙拔除的为与不为[J]. 中华口腔医学研究杂志(电子版), 2023, 17(06): 389-393.
[2] 邓超华, 李炯明, 刘建和, 方克伟, 王光, 李沛, 段飞. 经皮肾镜联合输尿管镜治疗双J管长期滞留并发结石[J]. 中华腔镜泌尿外科杂志(电子版), 2022, 16(04): 335-338.
[3] 王婷, 戴小霞, 刘权兴, 戴纪刚, 余江. 早期肺癌胸腔镜术后切口愈合不良的危险因素分析[J]. 中华肺部疾病杂志(电子版), 2022, 15(03): 416-418.
[4] 李延辉. 心血管植入型电子器械相关的病理学改变及其临床意义[J]. 中华心脏与心律电子杂志, 2023, 11(03): 182-187.
阅读次数
全文


摘要