Background And Purpose: Retrospective studies have suggested that routine stenting can be avoided following ureteroscopy. We prospectively analyzed the need for routine ureteral stent placement in patients undergoing ureteroscopic procedures.
Patients And Methods: Fifty-five consecutive patients (60 renal units) were randomized into either a stent or a no-stent group following ureteroscopy with either a 7.5F semirigid or a 7.5F flexible ureteroscope for treatment of calculi (holmium laser or pneumatic lithotripsy) or transitional-cell carcinoma (holmium laser). Intraoperative variables assessed included total stone burden, the need for ureteral dilation, and overall operative times. All patients were evaluated by questionnaire on postoperative days 0, 1, and 6 with regard to pain, frequency, urgency, dysuria, and hematuria.
Results: Of the 60 renal units treated, 38 received ureteral stents (mean 5.2 days), and 22 were treated without a stent. All 10 patients requiring ureteral balloon dilation had stents placed and were removed from the analysis. There was no significant difference between the groups with regard to age, sex, or stone burden. Operative time was decreased in the no-stent group (43 minutes v 55 minutes; P = 0.013). Flank discomfort was significantly less common in the no-stent group on days 0, 1, and 6 (P = 0.004, P = 0.003, P < 0.001, respectively), as was the incidence of suprapubic pain on day 6 (P = 0.002). There was no difference in urinary frequency, urgency, or dysuria between the groups on postoperative day 1, but all these symptoms were significantly reduced in the no-stent group on day 6 (P < 0.001, P < 0.001, P = 0.002, respectively). There was no significant difference in patient-reported postoperative hematuria in either group. One patient in each group developed a urinary tract infection. One patient in the no-stent group developed ureteral obstruction in the postoperative period that necessitated stenting, and one patient in the stent group experienced stent migration necessitating removal.
Conclusions: Routine ureteral stenting does not appear to be warranted in those patients who do not require ureteral dilation during ureteroscopic procedures. Ureteral stent placement following ureteroscopy may be avoided, thereby reducing operative time, surgical costs, and patient morbidity.
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http://dx.doi.org/10.1089/089277902753483646 | DOI Listing |
Surg Endosc
December 2024
Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Background And Aims: Self-expanding metal stents (SEMSs) are effective for symptom palliation in patients with esophageal obstruction. However, their placement can lead to adverse events such as stent migration and restenosis. A novel fully covered SEMS (FCSEMS) with antimigration properties has been developed to address these issues.
View Article and Find Full Text PDFMedicina (Kaunas)
November 2024
Hepatibiliopancreatic and Transplant Department, General and Digestive Surgery, Hospital Clinic, University of Barcelona, C. Villarroel, 170, 08036 Barcelona, Spain.
: Biliary fistulas (BFs) occur in approximately 3-8% of patients undergoing pancreaticoduodenectomy (PD), and the bile duct diameter ≤ 5 mm is the most important risk factor. The aim of this study was to evaluate the efficacy of biodegradable biliary stents (BSs) in reducing complications in patients undergoing robotic pancreaticoduodenectomy (RPD) with a bile duct diameter of ≤5 mm. : A retrospective single-centre observational study was conducted.
View Article and Find Full Text PDFJ Vasc Surg Venous Lymphat Disord
January 2025
Graduate School of Medicine, University of Wollongong, Wollongong, NSW, Australia.
J Am Coll Cardiol
December 2024
Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. Electronic address:
Background: Current guidelines recommend the perioperative continuation of aspirin in patients with coronary drug-eluting stents (DES) undergoing noncardiac surgery. However, supporting evidence is limited.
Objectives: This study aimed to compare continuing aspirin monotherapy vs temporarily holding all antiplatelet therapy before noncardiac surgery in patients with previous DES implantation.
Ann Surg
August 2024
Department of General and Digestive Surgery, Virgen de la Arrixaca University Hospital, IMIB-Arrixaca, Murcia, Spain.
Objective: We analyzed the use of a self-expandable absorbable biliary stent (SEABS) to reduce biliary complications in liver transplant (LT).
Background: Complications related to biliary anastomosis are a still a challenge in LT with a high impact on the patient outcomes and hospital costs.
Methods: This non-randomized prospective study was conducted between July 2019 and September 2023 in adult LT patients with duct-to-duct biliary anastomoses.
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