免膀胱镜拔出输尿管支架:只多要一条快微乔线和一条丝线

Non-cystoscopic removal of retained ureteral sents: What we need is just a segment of Vicryl Rapide and a silk thread

目的介绍一种使用快微乔线和丝线制备免膀胱镜拔除的输尿管支架管的方法。方法距输尿管支架管远端约12 cm(女性8 cm)管壁上缝合一条5-0快微乔线,长度适宜的丝线作为牵拉线缝合在输尿管支架管的远端,牵拉线沿输尿管支架管向近端折叠,它的中点与快微乔线打结固定,远端为自由端。快微乔线降解后解除了对牵拉线的固定,牵拉线顺着尿流出现在尿道外口,通过牵拉丝线就可以拔除输尿管支架管。结果研究纳入了40例患者,制备输尿管支架管的平均耗时为(2.03±0.29)min,39例(95%)牵拉线出现在尿道外口,平均时间为术后(18±3,15~21)d。拔除过程中疼痛视觉模拟评分为(0.82±0.34,0~3)。结论这种输尿管支架管可以避免膀胱镜拔除,成功率高而成本更低。

Objective To simply remove retained ureteral stents, we present a novel procedure in reforming the stents which can be draw out without cystoscope by using a Vicryl Rapide and a silk thread. Method One end of a silk stitch is sutured at the distal end of the ureteral stent and another end is free. The silk stitch is fold up along the ureteral stent and tied with the Vicryl Rapid at the lower part of the ureteral stent. After the Vicryl Rapide degraded, the free end of the silk stitch is released and appeared with the urinary stream in the urethra. Retained ureteral stent is removed just by pulling the silk stitch. Forty patients were enrolled in our research, and all the ureteral stents were placed with the novel procedure. Result The mean operation time for preparing the ureteral stent was(2.03±0.29) mins, and the mean time of silk stitch from operation to being visible at the urethral meatus was(18.3±3, 15-21) days. Thirty-nine(95%) of retained ureteral stents were successfully draw out by urologist or patients themselves without any surgical instruments. Conclusion This new non-cystoscopic removal procedure we have established has less operation time, high success rate and costs less.