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Vol. 46. Issue 4.
Pages 252-258 (May 2022)
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Vol. 46. Issue 4.
Pages 252-258 (May 2022)
Original article
Influence of double J stent in the complications of ureterovesical anastomosis during kidney transplantation
Influencia del catéter doble J en las complicaciones de la anastomosis vesicoureteral realizada durante el trasplante renal
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R. Quintana Álvarez
Corresponding author
, F. Herranz Amo, L. Esteban Labrador, G. Bueno Chomón, D. Subirá Ríos, C. Hernández Fernández
Servicio de Urología, Hospital General Universitario Gregorio Maranon, Madrid, Spain
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Figures (1)
Tables (5)
Table 1. Comparison of study groups.
Table 2. Univariable analysis for ureterovesical fistulas.
Table 3. Univariate analysis for ureterovesical anastomosis.
Table 4. Multivariable analysis for ureterovesical anastomosis stenosis.
Table 5. Recent literature results.
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Abstract
Introduction

Complications arising from ureterovesical anastomosis in kidney transplantation have an important influence on the success of the procedure. The most serious and frequent complications are fistula and stenosis of the ureterovesical junction. The placement of double J stents in anastomosis is currently recommended to reduce these complications.

Objective

The aim of the study is to evaluate whether the placement of a DJ stent affects complications of anastomosis.

Material and Methods

Retrospective analysis of 697 patients treated with cadaveric donor renal transplant in our center from 1999 to 2018 was performed. Results were compared according to double J stent placement and the surgical technique employed for anastomosis.

Results

Transplantation was performed without DJ placement in 51.7% of the patients, compared to 48.3% who were treated with DJ stent placement. The most commonly used technique was Lich-Gregoir. Ureterovesical fistula occurred in 5% of cases, and ureterovesical stenosis in 4.2%. DJ stent behaved as a protective factor for ureterovesical fistula but did not significantly influence the development of stenosis. The Taguchi technique greatly increased the risk of developing both ureterovesical fistula and stenosis. The incidence of stenosis and fistula was significantly higher when the Taguchi technique was combined with no DJ stent placement.

Conclusion

DJ stent placement acts as a protective factor for ureterovesical stenosis complications. The results of our study seem to agree with current literature.

Keywords:
Transplant
Anastomosis
DJ
Complications
Stenosis
Fistula
Resumen
Introducción

Las complicaciones surgidas de la anastomosis vesico-ureteral en el trasplante renal influyen de forma importante en el éxito del trasplante; siendo las más graves y frecuentes la fístula y la estenosis de la unión uretero-vesical. Actualmente se recomienda la colocación de catéteres doble J en esta anastomosis para reducir estas complicaciones.

Objetivo

El objetivo del estudio es evaluar si la colocación de un CDJ influye en las complicaciones de esta anastomosis.

Material y métodos

Se ha realizado un análisis retrospectivo de 697 pacientes tratados con trasplante renal de donante cadáver en nuestro centro desde 1999 hasta 2018; y se ha comparado los resultados en función del uso o no de catéter doble J y la técnica quirúrgica realizada en la anastomosis.

Resultados

En 51.7% de los pacientes no se colocó CDJ; frente a un 48.3% en los que sí se colocó. La técnica más utilizada fue Lich-Gregoir, Se produjo fístula uretero-vesical en un 5% de casos, y estenosis uretero-vesical en un 4.2%. El CDJ se comportó como factor protector de fístula ureterovesical, pero no influyó significativamente en el desarrollo de estenosis. La técnica de Taguchi multiplicó el riesgo de desarrollar tanto fístula como estenosis uretero-vesical. La incidencia de estenosis y de fístula fue significativamente mayor al combinar la técnica de Taguchi con la ausencia de catéter.

Conclusión

El CDJ actúa como factor protector para las complicaciones de la estenosis uretero-vesical. Los resultados de nuestro estudio parecen ir en concordancia con la literatura actual.

Palabras clave:
Trasplante
Anastomosis
Catéter
Complicaciones
Estenosis
Fístula

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