Factores asociados al fracaso en la colocación de catéteres doble J en pacientes con uropatía obstructiva por cáncer

Q4 Medicine

Revista mexicana de urologia Pub Date : 2016-03-01 DOI:10.1016/j.uromx.2015.10.005

I. Jiménez-Vázquez , I.A. Reyes-García , A.R. Aragón-Tovar , G.C. Palacios-Saucedo , A. García-Mendoza , A. Michel-Chávez , M.E. Huitrado-Duarte

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引用次数: 2

Abstract

Aim

To analyze the clinical, imaging, and surgical factors that are associated with failed double-J stent placement in patients with obstructive uropathy due to cancer.

Materials and methods

An analytic, cross-sectional study was conducted. The variables analyzed were: age, sex, oncologic diagnosis, clinical stage, diagnostic time course, treatment received, preoperative laboratory studies (Hb, leuc, Cr, BUN, urea), imaging studies (US or CAT), and the surgical attempt to place the double-J stent. A comparative analysis was done between the failed and successful placement groups. Statistical analysis was carried out using the Mann-Whitney U test and the chi-square test, and finally, the odds ratio with a 95% confidence interval was employed.

Results

Of the 48 patients, 27 had failed double-J stent placement and 21 had successful placement. Risk factors for failed placement were elevated preoperative levels of urea ≥ 40 mg/dL (OR: 16.67, CI: 2.66-134.92 [P = .0001]), creatinine ≥ 2 mg/dL (OR:7.27, CI:1.41-42.25 [P = .004]), and BUN ≥ 40 mg/dL (OR:4.00, CI: 0.93-18.06 [P = .031]) and a low Hb level ≤ 9 mg/dL (OR:6.32, CI:1.37-21.55 [P = .005]), as well as a deformed trigone (OR:3.29, IC:1.18-9.19 [P = .002]).

Conclusions

Elevated preoperative levels of creatinine, urea, and BUN, and a deformed bladder trigone are markers for failed double-J stent placement.

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癌症性阻塞性尿路病患者双J导管放置失败的相关因素

目的分析癌症性梗阻性尿路病变患者双j型支架置入术失败的临床、影像学及手术因素。材料与方法采用分析、横断面研究。分析的变量包括:年龄、性别、肿瘤诊断、临床分期、诊断时间、接受的治疗、术前实验室检查(Hb、leuc、Cr、BUN、尿素)、影像学检查(US或CAT)以及手术放置双j型支架的尝试。在失败和成功的安置组之间进行了比较分析。统计学分析采用Mann-Whitney U检验和卡方检验，最后采用95%置信区间的优势比。结果48例患者中，27例双j型支架置入失败，21例置入成功。术前尿素≥40 mg/dL (OR: 16.67, CI: 2.66-134.92 [P = .0001])、肌酐≥2 mg/dL (OR:7.27, CI:1.41-42.25 [P = .004])、BUN≥40 mg/dL (OR:4.00, CI: 0.93-18.06 [P = .031])、Hb低水平≤9 mg/dL (OR:6.32, CI:1.37-21.55 [P = .005])以及三角区变形(OR:3.29, IC:1.18-9.19 [P = .002])是放置失败的危险因素。结论术前肌酐、尿素、BUN升高及膀胱三角区变形是双j型支架置入失败的标志。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Revista mexicana de urologia Medicine-Urology

CiteScore

0.20

自引率

0.00%

发文量

期刊介绍： Revista Mexicana de Urología (RMU) [Mexican Journal of Urology] (ISSN: 0185-4542 / ISSN electronic: 2007-4085) is bimonthly publication that disseminates research by academicians and professionals of the international medical community interested in urological subjects, in the format of original articles, clinical cases, review articles brief communications and letters to the editor. Owing to its nature, it is publication with international scope that disseminates contributions in Spanish and English that are rigorously reviewed by peers under the double blind modality. Neither journalistic documents nor those that lack rigorous medical or scientific support are suitable for publication.