Ureteric stent in renal transplantation: to be or not to be?
DOI:
https://doi.org/10.14739/2310-1210.2016.5.82610Keywords:
Kidney Transplantation, Allografts, Urinary Fistula, StentsAbstract
Urological complications after kidney transplantation is still now one of the main reasons of worsening operation results. Most surgeons pay a lot of attention to the urinary fistulae. At verifiable urinary fistulae the next tactics significantly depends on the presence of urinary stent.
Subject of the work: to study the effectiveness of implantation as for double J-stents at kidney transplantation for prophylaxis of urinary fistulae.
Materials and methods. The analyzed results of kidney transplantation among 66 patients from 2012 to 2016. There were 37 (56.1 %) men, the average age of patients was 33.4±12.4 years. All the patients on early after surgical period were done the monitoring of clinic-biological indexes, ultrasonic examination with scanning of renal allograft. As for the aim of the work all the patients were divided into two groups:
The main group included 35 (53 %) recipients with kidney allografts, everyone of them was set uretero-bladder anastomosis on the double J-stent during the period from 11.2013 to 06.2016. The average age of patients was 32.6±9.2 years, there were 17 (48.6 %) men, 18 women (51.4 %).
Controlling group involved 31 (47 %) patients. During the period from 01.2012 to 10.2013 at kidney transplantation urinary stents were not used among the patients. The average age of recipients was 34.3±15.3 years, there were 20 (64.5 %) men, 11 women (35.5 %).
Results. According to the analysis of our clinic material the implantation of J-stent at kidney transplantation for prophylaxis of urinary fistulae is reliably (p<0.05) effective. In our research there is no connection (p>0.05) with the infection of urinary tracks with the presence of urinary stent.
Conclusions. Implantation of J-stent is effective and safe method of surgical prophylaxis of urinary fistulae and it can be routinely applied at kidney transplantation.
References
Danovitch, G. M. (Ed) (2010) Handbook of Kidney Transplantation. Lippincott Williams & Wilkins Handbook Series.
Humar, A., & Matas, A. J. (2008) Surgical complications after kidney transplantation. Semin. Dial, 18, 505–510.
Hernández, D., Rufino, M., Armas, S., González, A., Gutiérrez, P., Barbero, P., et al. (2006) Retrospective analysis of surgical complications following cadaveric kidney transplantation in the modern transplant era. Nephrol. Dial. Transplant, 10, 2908–2915. doi: 10.1093/ndt/gfl338.
Yankovoj, A. G., Vatazin, A. V., Smolyakov, A. V., Sinyutin, A. A., Stepanov, V. A., & Grankin, V. I. (2014) Transplantaciya pochki u pacientov s nevrologicheskimi zabolevaniyami [Kidney transplantation among the patients with urological diseases]. Moscow: MRSRCI. [in Russian].
Zokoev, A. K. (2010) Izolirovannaya i sochetannaya peresadka pochek i podzheludochnoj zhelezy (Dis… dokt. med. nauk). [Isolated and simultaneous transplantation of kidney and pancreas. Dr. med. sci. diss.]. Moscow. [in Russian].
Zavgorodny, S. N. (2004) Khirurhichni aspekty likuvannia terminalnoi stadii khronichnoi nyrkovoi nedostatnosti (Dis… dokt. med. nauk) [Surgical aspects of terminal kidney insufficiency treatment. Dr. med. sci. diss.]. Zaporizhzhia. [in Ukrainian].
Pilotovich, V. S., & Kalachic, O. V. (2009) Khronicheskaya bolezn' pochek. Metody zamestitel'noj terapii pochek [Chronic kidney disease. Methods of replacement kidney therapy]. Moscow. [in Russian].
Kälble, T. Alcaraz, A. Budde, K. Humke, U. Karam, G. Lucan, M., et al (2010) Guidelines on Renal Transplantation. European Association of Urology, 90.
Abhinav, H., Matas, A. J., & William, D. (2006) Payne Atlas of organ transplantation. London.
Zavhorodnii, S. M., Pastukhov, O. V., Poliakov, M. M., Horelyk, O. O., Laktionov, I. A. (patentee) (2009) Patent Ukrainy 44631 MPK (2009) A61V 17/00 shliakhy formuvannia anastomozu sechovoho mikhura z antyrefliuksnomu zakhysti pry peresadtsi donorskoi nyrky [Patent of Ukraine on the useful model 44631 IPC (2009) A61V 17/00 The way of formation urinary-bladder anastomosis with anti-reflux protection at kidney donor transplantation]. Biuleten, 19. [in Ukrainian].
Mangus, R. S., & Haag, B. W. (2004) Stented versus nonstented extravesical ureteroneocystostomy in renal transplantation: a meta-analysis. Am J Transplant, 4, 1889. doi: 10.1111/j.1600-6143.2004.00595.x.
Guvence, N., Oskay, K., Karabulut, I., & Ayli, D. (2009) Effects of ureteral stent on urologic complications in renal transplant recipients: a retrospective study. Ren Fail., 31(10), 899–903. doi: 10.3109/08860220903216105.
Indu, K. N., Lakshminarayana, G., Anil, M., Rajesh, R., George, K., Ginil, K., et al. (2012) Is early removal of prophylactic ureteric stents beneficial in live donor renal transplantation? Indian J Nephrol., 22(4), 275–9. doi: 10.4103/0971-4065.101247.
Gomes, G., Nunes, P., Castelo, D., Parada, B., Patrão, R., Bastos, C., et al. (2013) Ureteric stent in renal transplantation. Transplant Proc, 45(3), 1099–101. doi: 10.1016/j.transproceed.2013.02.086.
Chordia, P., Schain, D., & Kayler, L. (2013) Effects of ureteral stents on risk of bacteriuria in renal allograft recipients . Transpl Infect Dis., 15(3), 268–75.
Fockens, M. M., Alberts, V. P., Bemelman, F. J., Laguna Pes, M. P., & Idu, M. M. (2016) Internal or External Stenting of the Ureterovesical Anastomosis in Renal Transplantation. Urol Int., 96(2), 152–6. Doi: 10.1159/00044070.
Ranganathan, M., Akbar, M., Ilham, M. A., Chavez, R., Kumar, N., & Asderakis, A. (2009) Infective complications associated with ureteral stents in renal transplant recipients. Transplant Proc., 41(1), 162–4. doi: 10.1016/j.transproceed.2008.10.022.
Fayek, S. A., Keenan, J., Haririan, A., Cooper, M., Barth, R. N., Schweitzer, E., et al. (2012) Ureteral stents are associated with reduced risk of ureteral complications after kidney transplantation: a large single center experience. Transplantation, 93(3), 304–8. doi: 10.1097/TP.0b013e31823ec081.
Harza, M., Baston, C., Preda, A., Olaru, V., Ismail, G., Domnisor, L., et al. (2014) Impact of ureteral stenting on urological complications after kidney transplantation surgery: a single-center experience. Transplant Proc., 46(10), 3459–62. doi: 10.1016/j.transproceed.2014.08.051.
Mathe, Z., Treckmann, J. W., Heuer, M., Zeiger, A., Sauerland, S., Witzke, O., & Paul, A. (2010) Stented ureterovesical anastomosis in renal transplantation: does it influence the rate of urinary tract infections? Eur J Med Res., 15, 297–302.
Dolgov, V. V., & Menshikov, V. V. (Eds) (2012) Klinicheskaya laboratornaya diagnostika: nacional'naya direktiva [Clinical laboratory diagnosis: national guideline]. (Vol. 2). Moscow: GEOTAR-Media. [in Russian].
Sinangil, A., Celik, V., Barlas, S., Akin, E. B., & Ecder, T. (2014) Should transplant ureter be stented routinely or not? Eur Rev Med Pharmacol Sci., 18(23), 3551–6.
Downloads
How to Cite
Issue
Section
License
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access)
