Xu Hongye,Zhang Lingling,Du Guoqiang,et al.Analysis of risk factors of double J stent-related infection after laparoscopic pyeloplasty[J].Journal of Clinical Pediatric Surgery,,20():334-339.[doi:10.12260/lcxewkzz.2021.04.007]
Click Copy

Analysis of risk factors of double J stent-related infection after laparoscopic pyeloplasty

Journal of Clinical Pediatric Surgery[ISSN:1671-6353/CN:43-1380/R] volume: 第20卷 Number: 2021 04 Page: 334-339 Column: 专题·儿童肾积水分肾功能评估 Date of publication: 2021-04-28
Author(s):
Xu Hongye1;  Zhang Lingling2;  Du Guoqiang1;  Wu Rongde1;  Liu Wei1
1. Department of Pediatric Surgery, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250021, China;
2. Department of Pediatric Surgery, Shandong Provincial Hospital, Affiliated to Shandong First Medical University, Jinan 250021, China
Keywords:
Ureteropelvic Junction Obstruction; Laparoscopy; Urologic Surgical Procedures; Postoperative Complications; Drainage; Infection; Pyeloplasty
CLC:
R726.9;R692.2;R693
DOI:
10.12260/lcxewkzz.2021.04.007
Abstract:
Objective To explore the risk factors of double J stent-related urinary tract infection after laparoscopic pyeloplasty(LP) in patients with ureteropelvic junction obstruction(UPJO).Methods A total of 121 UPJO children undergoing primary transperitoneal LP between November 2015 and October 2020 were retrospectively reviewed.Double J stents were inserted.According to the occurrence of urinary tract infection during indwelling double J stent, they were divided into infection and non-infection groups.Differences in age, body weight, gender, sideness, preoperative presentation, anteroposterior pelvic diameter, renal cortical thickness, split renal function and type of double J stent were compared.Results Double J stent related infection occurred in 14 cases(11.57%).Statistical analysis revealed no significant inter-group difference in gender, sideness, anteroposterior pelvic diameter, renal function or double J tube type.However, age(P=0.02), body weight(P=0.02), preoperative presentation(P=0.04) and renal cortex thickness(P=0.003) were significantly different between two groups.Body weight <13.75 kg and renal cortical thickness <0.25 cm were risk factors of postoperative double J stent-related infection.Conclusion Double J stent-related infection is a common complication after LP.Body weight and renal cortical thickness are risk factors for this complication.Children with low weight and renal cortical thickness should be closely watched for the occurrence of double J stent-related infection.

References:

1 Turner RM 2nd,Fox JA,Tomaszewski JJ,et al.Laparoscopic pyeloplasty for ureteropelvic junction obstruction in infants[J].J Urol,2013,189(4):1503-1507.DOI:10.1016/j.juro.2012.10.067.
2 肖兴望,何大维.儿童肾盂输尿管连接处梗阻肾积水超声图像与非手术治疗预后相关性研究进展[J].中华实用儿科临床杂志,2019,34(11):873-876.DOI:10.3760/cma.j.issn.2095_428X.2019.11.018. Xiao XW,He DW.Research advances of correlations between ultrasonography and prognosis of non-surgical treatment to hydronephrosis caused by ureteropelvic junction obstruction in children[J].Chinese Journal of Applied Clinical Pediatrics,2019,34(11):873-876.DOI:10.3760/cma.j.issn.2095_428X.2019.11.018.
3 Chen JC,Zhang QL,Wang YJ,et al.Laparoscopic disconnected pyeloplasty to treat ureteropelvic junction obstruction(UPJO) in children[J].Med Sci Monit,2019,25:9131-9137.DOI:10.12659/MSM.918164.
4 Castillo OA,Cabrera W,Aleman E,et al.Laparoscopic pyeloplasty:technique and results in 80 consecutive patients[J].Actas Urol Esp,2014,38(2):103-108.DOI:10.1016/j.acuro.2013.04.010.
5 Rassweiler JJ,Teber D,Frede T.Complications of laparoscopic pyeloplasty[J].World J Urol,2008,26(6):539-547.DOI:10.1007/s00345-008-0266-z.
6 Soulié M,Salomon L,Patard JJ,et al.Extraperitoneal laparoscopic pyeloplasty:a multicenter study of 55 procedures[J].J Urol,2001,166(1):48-50.
7 Ceyhan E,Ileri F,Ceylan T,et al.Predictors of Recurrence and Complications in Pediatric Pyeloplasty[J].Urology,2019,126:187-191.DOI:10.1016/j.urology.2019.01.014.
8 He Y,Song H,Liu P,et al.Primary laparoscopic pyeloplasty in children:A single-center experience of 279 patients and analysis of possible factors affecting complications[J].J Pediatr Urol,2020,16(3):331.e1-e11.DOI:10.1016/j.jpurol.2020.03.028.
9 刘鑫,刘舸,杨屹.儿童原发性膀胱输尿管反流手术干预相关因素分析[J].临床小儿外科杂志,2019,18(10):830-834.DOI:10.3969/j.issn.1671-6353.2019.10.006. Liu X,Liu G,Yang Y.Predicative factors and optimal timing for surgical repair in children with primary vesicoureteral reflux[J].J Clin Ped Sur,2019,18(10):830-834.DOI:10.3969/j.issn.1671-6353.2019.10.006.
10 Imam MS,Al Farooq MA,Sarwar MKA,et al.A comparison between short-and long-term D-J stent in Anderson-Hynes pyeloplasty for pelvi-ureteric junction obstruction[J].Pediatr Surg Int,2020,36(11):1363-1370.DOI:10.1007/s00383-020-04734-9.
11 李丹,吴轶璇,丁雪芹,等.小儿肾盂输尿管成形术后尿路感染与置管方式及时间的关联性分析[J].中华医院感染学杂志,2018,28(15):2381-2384,2393.DOI:10.11816/cn.ni.2018-172983. Li D,Wu YX,Ding XQ,et al.Association between postoperative urinary tract infections and catheterization placement and time after pediatric ureteropelvic junction angioplasty[J].Chinese Journal of Nosocomiology,2018,28(15):2381-2384,2393.DOI:10.11816/cn.ni.2018-172983.
12 石从整,周琼,蒋立新,等.双J管相关泌尿系感染临床特点分析[J].武汉大学学报(医学版),2020,41(3):448-452.DOI:10.14188/j.1671-8852.2019.0382. Shi CZ,Zhou Q,Jiang LX,et al.Clinical characteristics and mechanism of double J tube related infection[J].Medical Journal of Wuhan University,2020,41(3):448-452.DOI:10.14188/j.1671-8852.2019.0382.
13 Fedelini P,Verze P,Meccariello C,et al.Intraoperative and postoperative complications of laparoscopic pyeloplasty:a single surgical team experience with 236 cases[J].J Endourol,2013,27(10):1224-1229.DOI:10.1089/end.2013.0301.
14 Badawy H,Saad A,Fahmy A,et al.Prospective evaluation of retroperitoneal laparoscopic pyeloplasty in children in the first 2 years of life:Is age a risk factor for conversion?[J].J Pediatr Urol,2017,13(5):511.e1-e4.DOI:10.1016/j.jpurol.2017.03.025.
15 Ludwikowski BM,Botl?nder M,González R.The BULT Method for Pediatric Minilaparoscopic Pyeloplasty in Infants:Technique and Results[J].Front Pediatr,2016,4:54.DOI:10.3389/fped.2016.00054.
16 Zamfir Snykers C,De Plaen E,Vermersch S,et al.Is laparoscopic pyeloplasty for ureteropelvic junction obstruction in infants under 1 year of age a good option?[J].Front Pediatr,2019,7:352.DOI:10.3389/fped.2019.00352.
17 张一帆,郝春生,任玉乾.腹腔镜下Anderson-Hynes肾盂输尿管成形术治疗6个月以下婴儿肾盂输尿管连接部梗阻[J].中国微创外科杂志,2019,19(7):587-591.DOI:10.3969/j.issn.1009-6604.2019.07.004. Zhang YF,Hao CS,Ren YQ.Laparoscopic Anderson-Hynes pyeloureteroplasty for ureteropelvic junction obstruction in infants aged under 6 months[J].Chinese Journal of Minimally Invasive Surgery,2019,19(7):587-591.DOI:10.3969/j.issn.1009-6604.2019.07.004.
18 柴红超,周云,王静茹,等.肾积水患者并发症危险因素Logistic回归分析[J].临床军医杂志,2019,47(11):1268-1269,1275.DOI:10.16680/j.1671-3826.2019.11.40. Chai HC,Zhou Y,Wang JR,et al.Logistic regression analysis of risk factors for complications in children with hydronephrosis[J].Clinical Journal of Medical Officers,2019,47(11):1268-1269,1275.DOI:10.16680/j.1671-3826.2019.11.40.

Memo

收稿日期:2020-12-29。
通讯作者:刘伟,Email:lemontree1119@126.com

Last Update: 1900-01-01