Influence of double J stent in the complications of ureterovesical anastomosis during kidney transplantation

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 current...

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Bibliographic Details
Published in:Actas urológicas españolas (English ed.) 2022-05, Vol.46 (4), p.252-258
Main Authors: Quintana Álvarez, R., Herranz Amo, F., Esteban Labrador, L., Bueno Chomón, G., Subirá Ríos, D., Hernández Fernández, C.
Format: Article
Language:eng ; spa
Subjects:
Anastomosis
Catéter
Complicaciones
Complications
Estenosis
Fistula
Fístula
Stenosis
Transplant
Trasplante
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Summary: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. The aim of the study is to evaluate whether the placement of a DJ stent affects complications of anastomosis. 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. 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. DJ stent placement acts as a protective factor for ureterovesical stenosis complications. The results of our study seem to agree with current literature. 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. El objetivo del estudio es evaluar si la colocación de un CDJ influye en las complicaciones de esta anastomosis. 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. 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
ISSN:2173-5786
2173-5786
DOI:10.1016/j.acuroe.2021.11.002