Poređenje i vrednovanje simptoma nakon nekomplikovane ureteroskopske litotripsije kod bolesnika sa i bez ugrađenog stenta
Sažetak
Uvod/Cilj. Ureterorenoskopsko sitnjenje i uklanjanje kamena predstavlja lečenje izbora prilikom zbrinjavanja ureteralnog kamena naročito srednjeg i donjeg uretera, i smatra se osnovnim zbrinjavanjem. Cilj rada bio je da se ocene simptomi, neophodnost potencijalne koristi i neželjeni efekti plasiranja ureteralnog stenta nakon nekomplikovane ureteroskopske litotripsije (URSL). Metode. U ovoj retrospektivno-prospektivnoj studiji, ispitano je 125 bolesnika koji su bili podvrgnuti URSL. Bolesnici su podeljeni u dve grupe: sa ugrađenim stentom (ispitivani bolesnici, 59) i bez stenta (kontrole, 66 bolesnika). Ishodi koji su mereni i poređeni između dve grupe obuhvatali su: stopu odsustva kalkulusa, postoperativni bol kod bolesnika ocenjen pomoću skale, simptome donjeg urinarnog trakta (SDUT), potrebu za neplaniranim bolničkim lečenjem, komplikacije povezane sa stentom i funkcionalni oporavak u formi povratka na uobičajene fizičke aktivnosti. Rezultati. Povoljan ishod, definisan kao odsustvo kalkulusa nakon 12 nedelja, postignut je kod svih 125 (100%) bolesnika. Nije bilo statistički značajne razlike između dve grupe u stopi odsustva kalkulusa. SDUT su bili češći u grupi sa plasiranim stentom, sa statistički značajnom razlikom u domenu učestalosti mokrenja, odnosno urgencije (p = 0,0314). Postojala je statistički značajna razlika između grupa u prosečnom trajanju operacije i prosečnoj hospitalizaciji, srednjoj vrednosti ocene bola na vizualnoj analognoj skali (VAS) i u upotrebi neopijatnih analgetika. Na dan operacije i sve do trećeg postoperativnog dana (POD 3), odnosno petog postoperativnog dana (POD 5), ocena bola (p = 0,0001), kao i potreba za neopijatnim analgeticima (p = 0.001) bila je viša među bolesnicima sa stentom u poređenju sa kontrolama. Zaključak. Rutinsko ugrađivanje ureteralnog stenta nakon nekomplikovane URSL nije obavezno i može biti povezano sa neželjenim efektima stenta. URSL je bezbedna procedura i bez ugrađivanja stenta na kraju intervencije.
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