Comparación de los resultados del trasplante renal pediátrico según la duración del catéter ureteral: una revisión sistemática de los Grupos de Trabajo de Urología Pediátrica y Trasplante Renal de la Sección de Jóvenes Urólogos Académicos

IF 1.2 4区 医学 Q3 UROLOGY & NEPHROLOGY
I.B. de Angst , M. Reichert , M.I. Dönmez , Y. Quiroz , F. O’Kelly , S. Sforza , W.M. Bramer , B. Bañuelos , E. Bindi , I. Selvi , F. Brandt , E. Starink , J. Stufken , A. Territo , A. López-Abad , R.J.M. Lammers , L.A. ‘t Hoen
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引用次数: 0

Abstract

Introduction and objectives

Urological complications are common after kidney transplantation (KTx), mostly in the form of ureterovesical obstruction or leakage. Routine ureteral stenting was previously shown to reduce these complications on the expense of other complications such as urinary tract infections. There is no consensus on optimal duration of stents, and relevant literature on this topic is lacking. The aim of this systematic review is to summarize and compare the incidences of stent-related complications using short (< 2 weeks) and long (≥ 2 weeks) stent duration after pediatric KTx.

Material and methods

A systematic search in Embase, MEDLINE, Cochrane, and ClinicalTrial.gov was performed. Studies reporting on children (0-18 years) undergoing KTx with intraoperative ureteral stenting with at least one month follow up were included. Data on surgical and outcome characteristics were extracted.

Results

From a total of 322 articles, 14 studies were included, reporting on 971 pediatric KTx of whom 411 were female (42%). Sample sizes ranged from 32 to 146 patients. Mean or median age at time of transplantation ranged from 3.36 to 14.7 years. A systematic synthesis approach was used to summarize results. Of the 4 comparative studies, only one showed significantly more post-transplant urinary tract infections in the long duration group, without a significant difference in other urological complications.

Conclusions

Due to lack of good quality studies, it remains uncertain whether a short stent duration is safer and more feasible for reducing the incidence of stent-related complications in pediatric KTx, while also preventing stenosis or leakage at the ureterovesical anastomosis.
按尿道导管长度划分的儿科肾移植结果比较:由青年泌尿科学术组儿科泌尿学和肾移植工作组进行的系统综述
导读与目的肾移植术后泌尿系统并发症很常见,主要表现为输尿管梗阻或渗漏。常规输尿管支架置入术在减少尿路感染等其他并发症的基础上减少了这些并发症。关于支架的最佳持续时间尚无共识,且缺乏相关文献。本系统综述的目的是总结和比较儿童KTx术后使用短(2周)和长(≥2周)支架的支架相关并发症的发生率。材料和方法在Embase、MEDLINE、Cochrane和ClinicalTrial.gov中进行系统检索。研究报告的儿童(0-18岁)接受KTx术中输尿管支架置入至少一个月的随访。提取手术和结局特征的数据。结果从322篇文献中纳入14项研究,报告了971例儿科KTx,其中411例为女性(42%)。样本量从32例到146例不等。移植时的平均或中位年龄为3.36至14.7岁。采用系统综合的方法对结果进行总结。在4项比较研究中,只有一项研究显示长时间组移植后尿路感染明显增加,其他泌尿系统并发症无明显差异。结论由于缺乏高质量的研究,对于减少小儿KTx支架相关并发症的发生率,同时防止输尿管膀胱吻合口狭窄或渗漏,短支架时间是否更安全、更可行尚不确定。
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
Actas urologicas espanolas
Actas urologicas espanolas UROLOGY & NEPHROLOGY-
CiteScore
1.90
自引率
0.00%
发文量
98
审稿时长
46 days
期刊介绍: Actas Urológicas Españolas is an international journal dedicated to urological diseases and renal transplant. It has been the official publication of the Spanish Urology Association since 1974 and of the American Urology Confederation since 2008. Its articles cover all aspects related to urology. Actas Urológicas Españolas, governed by the peer review system (double blinded), is published online in Spanish and English. Consequently, manuscripts may be sent in Spanish or English and bidirectional free cost translation will be provided.
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