Can double J stent complications be reduced in pediatric patients?

M Bayarri Moreno, I Planas Díaz, I Casal Beloy, R M Romero Ruiz
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引用次数: 1

Abstract

Objective: The use of double J (DJ) stents is frequent in urological pediatrics, but it is not exempt from morbidity. The objective of this study was to describe the risk factors (RF) of DJ complications in pediatric patients, and to analyze the quality of the information provided to the families with respect to the stent.

Materials and methods: A retrospective study of patients undergoing surgery with DJ placement in the urology department from 2017 to 2022 was carried out. Study patients were divided into two groups -complicated (C) and non-complicated (NC). A multivariate analysis was performed to identify complication-related RFs, and a quality analysis as perceived by the families was conducted by means of a satisfaction survey (0 = total dissatisfaction; 10 = maximum satisfaction).

Results: 180 patients were included (236 DJs). The main diagnoses included renal transplantation (29.8%), ureteropelvic stenosis (26%), and urolithiasis (20.7%). Complication rate was 21.9%, with a mean comprehensive complication index (CCI) of 26.8. Prophylactic antibiotic therapy was not associated with fewer complications (97.3% vs. 98.1%; p= 0.727). Complication RFs included more than one stent (p< 0.001; OR= 6.628) and bilateral placement (p< 0.05; OR= 4.871). Poor registration in the medical records was associated with greater complications (p= 0.025). In the information quality survey, 20% reported a score lower than 7/10.

Conclusions: DJ-associated morbidity has a direct relationship with DJ duration, bilaterality, and carrying more than one stent in a lifetime. Adequate registration in the medical records is associated with shorter DJ duration, and therefore, fewer complications. Antibiotic prophylaxis did not reduce complications, which means its routine use should be reconsidered.

儿童患者双J支架并发症可以减少吗?
目的:双J(DJ)支架的使用在泌尿外科儿科是常见的,但也不能避免其发病率。本研究的目的是描述儿科患者DJ并发症的危险因素(RF),并分析提供给家庭的支架相关信息的质量。材料和方法:对2017年至2022年在泌尿外科接受DJ植入手术的患者进行回顾性研究。研究患者被分为两组——复杂组(C)和非复杂组(NC)。进行多变量分析以确定与并发症相关的RFs,并通过满意度调查进行家庭感知的质量分析(0= 完全不满;10= 结果:纳入180例患者(236例DJ)。主要诊断包括肾移植(29.8%)、肾盂输尿管狭窄(26%)和尿石症(20.7%),并发症发生率为21.9%,平均综合并发症指数(CCI)为26.8。预防性抗生素治疗与减少并发症无关(97.3%vs.98.1%;p= 0.727)。并发症射频包括多个支架(结论:DJ相关的发病率与DJ持续时间、双侧性和一生中携带一个以上支架有直接关系。医疗记录中的充分登记与DJ持续期较短有关,因此并发症较少。抗生素预防并没有减少并发症,这意味着应重新考虑其常规使用。)。
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