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【Objective】 To explore the application of 1.2 mm×35 mm thin walled, long oblique angle syringe needle guided double-J tube insertion through abdominal wall in total laparoscopic ileal neobladder surgery. 【Methods】 Clinical data of 5 patients undergoing total laparoscopic ileal neobladder surgery in our hospital during Dec.2020 and Jan.2022 were retrospectively analyzed. Under laparoscopy and direct vision, 3 cm above pubic symphysis was taken as the puncture point, and an syringe needle was inserted to establish a channel. After that, a double-J tube was inserted under the guidance of the guide wire through the needle. 【Results】 The double-J tube was successfully implanted in all 5 patients. The time needed was 2-4 min, with an average of 3 min. 【Conclusion】 Under the guidance of a 1.2 mm×35 mm syringe needle, the placement of a double-J tube through the abdominal wall in total laparoscopic ileal neobladder surgery is safe, effective, simple and accurate. It can not only preserve the original operation channel without destroying the pneumoperitoneum, but also shorten the operation time. It is a new auxiliary means in total laparoscopic ileal neobladder surgery.
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Objective:To explore the effects of video combined with action-oriented teaching on self-management skill and complications in patients with urinary calculus after indwelling tube, and to provide basis for improving the effect of clinical health education.Methods:A total of 100 patients with urinary calculus after indwelling double J tube from department of urological surgery of the First Affiliated Hospital of Zhengzhou University from March 2018 to October 2019 were divided into experimental group and control group, 45 cases in each group by ramdom digits table method. The patients in the control group recieved routine care and oral health education, the experimental group implemented video combined with action-oriented teaching. The levels of health self-management skill as well as complications were compared between the two groups.Results:After extubation, self-management behavioral scores, self-management cognitive scores, self-management environment scores and total scores in Adults Health Self-Management Skill Rating Scale were (54.26 ± 4.39), (57.22 ± 6.93), (39.91 ± 7.91), (151.39 ± 13.37) points, which were significantly higher than those in the control group (47.92 ± 6.96) , (52.69 ± 6.45), (34.63 ± 8.53), (135.24 ± 12.71) points, the difference were statistically significant ( t values were 2.64-6.04, all P<0.05). The total incidence of tube related complications was 39.1% (18/46) in the experimental group, which was significantly lower than that in the control group 61.2% (30/49). The incidence of lumbago, bladder irritation symptom and shematuria were 10.9% (5/46), 13.0% (6/46), 10.9% (5/46) in the experimental group, significantly lower than those in the control group 28.6% (14/49), 32.7% (16/49), 30.6%(15/49), the differences were statistically significant ( χ2 values were 4.63-5.56, all P<0.05). Conclusions:Video combined with action-oriented teaching can effectively improve self-management skill and reduce tube-related complications of patients with urinary calculi after indwelling double J tube.
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Objective@#To explore the application effect of standardized video combined with feedback method in health education for patients with urinary calculi after double J tube indwelling operation, and to provide basis for improving the effect of clinical health education.@*Methods@#One hundred and fourteen patients were selected from October 2018 to March 2019 for the first time after the operation of urinary calculi with double J-tube indwelling after holmium laser lithotripsy. Fifty-six patients were selected as the control group and 58 cases as the experimental group by random number table method. The control group was given routine nursing and oral health education, while the experimental group was given standardized video combined with feedback education on the basis of routine nursing. The level of knowledge, belief and behavior, the incidence of complications and satisfaction with nursing health guidance were compared between the two groups after intervention.@*Results@#The scores of knowledge, belief and action in the experimental group were (7.14 ± 1.39), (30.17 ± 2.62) and (67.50 ± 3.40) respectively, which were higher than those in the control group (5.39 ± 1.29), (28.54 ± 2.29) and (62.23 ± 4.39). The difference was statistically significant (t=5.83, 3.55, 7.18, P<0.01). The incidence of complications was 34.48% (20/58) in the experimental group, which was significantly lower than 62.50% (35/56) in the control group (χ2=8.957, P<0.01). The average rank of satisfaction with nursing health guidance in the experimental group was 66.03, which was significantly higher than that in the control group. The difference was statistically significant (Z=-3.157, P=0.02).@*Conclusions@#Standardized video education combined with feedback method can improve patients′ awareness of vascular behavior after double J tube indwelling for urinary calculi, reduce complications related to double J tube indwelling, and improve patients′ satisfaction with nursing education.
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Objective To explore species distribution of bacteria colonizing the indwelling double J tube in pregnant women.Methods From March2013 to December 2017, patients with double J tube during pregnancy in urology department of a hospital were collected.According to the time of indwelling double J tubes, they were divided into group A (indwelling time≤1 month) and group B (indwelling time＞1 month).All patients underwent bladder urine and double J tube bacterial culture before and after extubation.Species and positive detection rates of bacteria in bladder urine and double J tube between two groups were compared and analyzed.Results A total of 237 pregnant women with ureteral obstruction were included in the study, 129 cases in group A and 108 in group B.A total of 78 strains of bacteria were isolated in double J tube culture, 35 strains in group A and 43 in group B.Gram-negative bacilli were predominant in both groups, accounting for 54.29％ and 67.44％ respectively, followed by grampositive cocci, accounting for 37.14％ and 25.58％ respectively;isolated bacteria were Escherichia coli (n=30), Enterococcus spp. (n=12), Staphylococcus spp. (n=12), Klebsiella pneumoniae (n=11), Pseudomonas aeruginosa (n=7) and so on.Positive rate of double J tube bacterial culture was higher than that of bladder urine culture in both group A and group B, difference were both statistically significant (both P＜0.05).Positive rate of double J tube bacterial culture in group B was higher than that in group A (39.81％ VS 27.13％, P＜0.05), but there was no significant difference in the positive rate of bladder urine culture between group A and group B (P＞0.05).Conclusion The main colonized bacteria for pregnant women who are inserted double J tubes are gram-negative bacilli, the longer time the double J tube is placed, the higher rate the bacteria colonize and the higher positive of bacterial culture.
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The long-term retention of ureteral stent (double J tube) leads to the displacement and fracture of double J tube, and the formation of peritube stones, which are the main causes of the difficult decannulation through conventional cystoscopy. Its clinical treatment is more complex, involving different minimally invasive endoscopic techniques, and even by traditional open surgery. In recent years, more and more reports on the difficulty of removing double J tubes after retention. Among them, the multi-mirror combined operation method has been recommended, and the KUB scoring system based on imaging examination contributes to evaluate the difficulty of operation and prognosis of patients before operation. This article reviews the diagnosis of double J tube retention, the causes of difficult decannulation, preoperative preparation and progress of surgical management.
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Objective To investigate the clinical value of different double-J tube indwelling time in the treatment of ureteral stone-street complications after flexible ureteroscope lithotripsy. Methods Clinical data of 64 kidney calculi patients with ureteral stone-street complications after flexible ureteroscope holmium laser lithotripsy were retrospectively analyzed. The patients were divided into observation group (extubating the double-J tube 2 weeks after the surgery) and control group (retaining the double-J tube) with 32 cases in each group. The calculi clearance results and complication were compared between 2 groups. Results The success rate of stone removal in observation group was significantly higher than that in control group: 100.0% (32/32) vs. 65.6%(21/32), the calculi elimination time was significantly shorter than that in control group:(26.4 ± 6.6) d vs. (45.3 ± 10.9) d, the treatment cost was significantly lower than that in control group:(768.4 ± 152.6) yuan vs. (1 262.3 ± 156.8) yuan, the incidences of irritation symptoms of bladder and macroscopic hematuria were significantly lower than those in control group: 15.6% (5/32) vs. 90.6%(29/32) and 15.6% (5/32) vs. 100.0% (32/32), and there were statistical differences (P0.05). Conclusions Removing the double-J tube 2 weeks after flexible ureteroscope lithotripsy results in higher stone clearance rate and less complications compared with retaining the double-J tube. It can reduce the occurrence of irritation symptoms of bladder, macroscopic hematuria and treatment cost.
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Objective To assess the impact of preoperative ureteral stenting on outcome of flexible ureteroscopic lithotripsy . Methods The clinic data of flexible ureteroscope lithotripsy were analyzed retrospectively .All 52 eligible patients were divided into three group :goup A(no preoperative ureteral stenting );group B (preoperative ureteral stenting for 3-10 days);group C(preopera‐tive ureteral stenting for two weeks or more ) .The application of ureteral access sheath ,operation time ,stone free rates ,hospital stays ,complications were compared among the three groups .Results There were no significant differences in aging ,gender ,stone size , distribution ,average hospitalization days ,postoperative complications among the three groups (P>0 .05) .There were significantly differ‐ences between group A and group B ,group C(P0 .05) on the suc‐cess rate of indwelling ureteral access sheath ,average operation time ,stone free rate .Conclusion Preoperative ureteral stenting could en‐hance the success rate of indwelling ureteral access sheath ,shorten the operation time ,improve the stone free rate .There was similar out‐come of flexible ureteroscopic lithotripsy between preoperative ureteral stenting for 3-10 days and two weeks or more .
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Objective To investigate the effects of the double J tube in treating drug -crystalline upper uri-nary tract obstruction.Methods There were 12 cases of drug -crystalline urinary tract obstruction,which were diag-nosed by CT for urinary tract obstruction.With the help of cystoscope,we retrograde placed the double -J tube in all the 12 patients who with persistently elevated serum creatinine in the next day of admission.Results Nine patients were successfully placed double J stent and serum creatinine of the patients decreased to normal rapidly.There were 2 patients with failed implantation and were with persistently elevated serum creatinine.1 patient with unilateral urina-ry tract obstruction was treated with conservative treatment and eventually cured.Conclusion Patients with drug -induced renal injury should have a routine bilateral ureteral CT scan,once they are clearly diagnosed as drug crystal upper urinary tract obstruction in them,timely placement of bilateral double J tube with the help of cystoscope,which was a simple and effective treatments.
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1?105/ml。These cases were assigned to A or B group randomly.The management of A group:double-J tubes were placed and retained for 2 weeks again,and used susceptible antibiotics for 2 weeks→ discontinued drugs for 1 week→urine cultured,PA(+)→used susceptible antibiotics for 2 weeks→discontinued drugs for 1 week→urine cultured,PA(+)→used susceptible antibiotics for 2 weeks;the management of B group:double-J tube(sCook,F6,America)were placed again,and used susceptible antibiotics for 2 weeks→discontinued drugs for 1 week→urine cultured,PA(+)→used susceptible antibiotics for 2 weeks,until the infection was cured,the double-J tube was removed after the infection was cured.Results:A group:double-J tubes were retained for 2 weeks additionally;4 patients were cured during the first two-week,2 patients were cured during the second two-week,the cure rate was 40%after two courses,one was cured during the third two-week,the cure rate was 46.7%after three courses.B group:double-J tubes was retained for 4～12 weeks(mean 8 weeks)additionally,3 patients were cured during the first two-week,9 patients were cured during the second two-week,the cure rate was 80%after two courses,2 patients were cured during the third two-week,the cure rate was 93.3%after three courses.The cure rate ofBgroup was significantlyhigher than Agroup after twocourses and three courses,the difference was significan(tP
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Objective To explore the selection and clinical effects of internal or external drainage for upper urinary tract obstruction complicated with acute renal failure.Methods A total of 25 cases of upper urinary tract obstruction complicated with acute renal failure were treated with double J(DJ) tube internal drainage(12 cases,15 times) or percutaneous nephrectomy(PCN) external drainage(19 cases,23 times).15 cases of obstruction were induced by tumor and 10 cases of obstruction induced by benign disease.Results The drainage treatments were performed successfully in 23 cases,with the success rate of PCN and DJ drainage being 86.9%(20/23) and 60.0%(9/15),respectively.Postoperative bleeding occurred in 1 patient with PCN.Conclusions PCN is superior to DJ in the treatment of malignant obstruction,but DJ internal drainage may be the first choice for non-malignant obstruction.
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Objective To devise an improved double J tube for ureteral stenting so as to simplify its postoperative removal. Methods One end of the double J tube was made blind and got through the urinary tract via the ureteral wall or via a weak point of the renal cortex.The blind end was then embeded in the subcutaneous tissue and the ureteral stent was left behind for 4～12 weeks.A small incision (0.5 cm) was made in order to withdraw the stent and cystoscopy could be avoided.The self devised tube has been clinically employed for 60 cases. Results The stent has been satisfactory in all the 60 cases and its postoperative removal has been easy with no need of cystoscopy. Conclusions The subcutaneous embedding of a blind end of double J tube is simple and effective and its postoperative withdrawal is easy with no need of cystoscopy.