Comparative analysis of the efficacy of double J tube and balloon dilation in retrograde intrarenal surgery

doi:10.3877/cma.j.issn.1674-3253.2019.05.006

Abstract

Abstract:

Objective

To compare the efficacy and safety of preoperative reserved double J catheter and balloon dilatation in the application of retrograde intra-renal surgery (RIRS).

Methods

Clinical data of 125 patients undergoing RIRS for unilateral ureteral dilatation in our hospital from May 2016 to May 2018 were retrospectively analyzed. Among them, 57 patients received reserved double J catheter for passive ureteral dilatation and 68 cases underwent primary balloon for active ureteral dilatation. General data and postoperative data were statistically analyzed between two groups.

Results

No statistical difference was observed in gender, age, stone site, the maximum diameter of stones and the number of multiple stones between the two groups (allP>0.05). The proportion of retained 16 F ureteral access sheath (UAS) in the reserved double J catheter group was significantly higher than that in the balloon dilation group (70.2% vs 30.9%,P<0.001). The score of pain assessment at postoperative 1 d in the reserved double J catheter group was remarkably lower compared with that in the balloon dilation group [(2.42±1.50) vs (3.82±1.92),P<0.001]. No statistical difference was observed in the success rate of one-stage UAS placement, operation time, stone clearance rate at postoperative 1-2 d, overall stone clearance rate, postoperative length of hospital stay and surgical complications between two groups (allP>0.05).

Conclusion

Reserved double J catheter and balloon dilatation are safe and effective in RIRS. The selection of ureteral dilatation approach depends on the physical conditions of patients, the expertise of physicians and hospital equipment,etc.

Key words: Flexible ureteroscope, Stone, Double J catheter, Balloon dilation, Ureteral access sheath

Chen Huang, Xun Li, Guibin Xu, Yuyu Xu, Yu Gan, Jian Liang, Yaoji Yuan, Dehui Lai, Weiqing Yang, Ming Sheng. Comparative analysis of the efficacy of double J tube and balloon dilation in retrograde intrarenal surgery[J]. Chinese Journal of Endourology(Electronic Edition), 2019, 13(05): 309-312.

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URL: https://zhqjmnmwkzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-3253.2019.05.006

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References 18

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组别	例数	性别（例）		年龄（岁，±s）	结石最大直径（mm，±s）	结石部位（例）		多发结石（例）	草酸钙结石（例）
组别	例数	男性	女性	年龄（岁，±s）	结石最大直径（mm，±s）	右侧	左侧	多发结石（例）	草酸钙结石（例）
预留双J管组	57	36	21	50±13	13±4	31	26	16	40
球囊扩张组	68	45	23	48±14	12±4	43	25	21	48
统计值	?	χ²=0.12		t=0.77	t=-0.91	χ²=1.01		χ²=0.12	χ²=0
P值	?	0.73		0.44	0.36	0.32		0.73	1

组别	例数	性别（例）		年龄（岁，±s）	结石最大直径（mm，±s）	结石部位（例）		多发结石（例）	草酸钙结石（例）
组别	例数	男性	女性	年龄（岁，±s）	结石最大直径（mm，±s）	右侧	左侧	多发结石（例）	草酸钙结石（例）
预留双J管组	57	36	21	50±13	13±4	31	26	16	40
球囊扩张组	68	45	23	48±14	12±4	43	25	21	48
统计值	?	χ²=0.12		t=0.77	t=-0.91	χ²=1.01		χ²=0.12	χ²=0
P值	?	0.73		0.44	0.36	0.32		0.73	1

组别	一次性放置UAS成功率[例（%）]	留置16 F UAS比例[例（%）]	手术时间（min，±s）	术后1~2 d结石清除率[例（%）]	总结石清除率[例（%）]	术后住院时间（d，±s）	并发症[例（%）]
预留置双J管组	53（93.0）	40（70.2）	77±33	39（68.4）	54（94.7）	4.3±2.5	3（5.3）
球囊扩张组	67（98.5）	21（30.9）	69±26	52（76.5）	64（94.1）	4.0±1.7	5（7.4）
统计值	1.30	19.20	-0.80	1.02	0.02	-0.10	-
P值	0.18	P<0.001	0.42	0.31	0.88	0.92	0.94

组别	一次性放置UAS成功率[例（%）]	留置16 F UAS比例[例（%）]	手术时间（min，±s）	术后1~2 d结石清除率[例（%）]	总结石清除率[例（%）]	术后住院时间（d，±s）	并发症[例（%）]
预留置双J管组	53（93.0）	40（70.2）	77±33	39（68.4）	54（94.7）	4.3±2.5	3（5.3）
球囊扩张组	67（98.5）	21（30.9）	69±26	52（76.5）	64（94.1）	4.0±1.7	5（7.4）
统计值	1.30	19.20	-0.80	1.02	0.02	-0.10	-
P值	0.18	P<0.001	0.42	0.31	0.88	0.92	0.94

组别	VRS评分（例）					VAS评分（分，±s）
组别	无	轻度	中度	重度	极重度	VAS评分（分，±s）
预留支架管组	5	40	10	2	0	2.42±1.50
球囊扩张组	0	30	30	6	2	3.82±1.92
统计值	-	χ²=8.450	χ²=10.06	χ²=0.71	-	t=-4.59
P值	0.018	0.003	0.002	0.40	0.50	<0.001

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