Optimal Timing for Removal of the Double-J Stent After Kidney Transplantation.
BACKGROUND
Urologic complications (UC) have gradually decreased in recent years after advanced surgical experience. The incidence of urologic complications varies between 0.22% and 30% in different medical studies. There is no routine usage of double-J stenting (DJS) during renal transplantation (RT) in the literature. It is a necessity, and optimal timing for stent removal is an important question for many transplantation centers.


METHODS
This study includes 818 renal transplant patients whose ureteroneocystostomy anastomoses were completed by use of the Lich-Gregorie procedure during a 2-year period at a transplantation center. We performed 926 renal transplantations at Antalya Medical Park Hospital Renal Transplantation Center between January 2014 and January 2016. The patients were divided into four groups according to the timing of DJS removal.


RESULTS
For group 1, removal time for DJS was between 5 and 7 days; group 2, Removal time for DJS was between 8 and 14 days; group 3, removal time for DJS was between 15 and 21 days; and group 4, removal time for DJS was later than 22 days. The patients were divided into two groups according to removal time of stent as 5 to 14 days and >15 days. DJS was performed again in the patients whose urine output was reduced during the first 5 days after removal of the DJS, whose creatine level increased, and whose graft ureter and collecting tubules were extended as an ultrasonographic finding.


CONCLUSIONS
There is no declared optimal time for the removal of DJS. The removal time was reported between postoperative first week and 3 months in some of the reports of RT centers, according to their protocols. We emphasize that the optimal time for the removal of DJS is 14 to 21 days after RT, based on the findings of our large case report study.
Medical Park Hospital, Department of General Surgery and Transplantation, Antalya, Turkey. Electronic address: dryucelyuksel@gmail.com.
Y
Y
Yuksel
Kemerburgaz University, Faculty of Medicine, Department of General Surgery, Istanbul, Turkey.
S
S
Tekin
Training and Research Hospital, Department of Anesthesia and Reanimasyon Unit, Antalya, Turkey.
D
D
Yuksel
Kemerburgaz University, Faculty of Medicine, Department of Urology, Istanbul, Turkey.
I
I
Duman
Kemerburgaz University, Faculty of Medicine, Department of Urology, Istanbul, Turkey.
M
M
Sarier
Medical Park Hospital, Department of General Surgery and Transplantation, Antalya, Turkey.
L
L
Yucetin
Ataturk Goverment Hostpital, Department of Chest Diseases, Antalya, Turkey.
K
K
Kiraz
Yuksek Ihtisas Training and Research Hospital, Department of Urology, Bursa, Turkey.
M
M
Demirbas
Medical Park Hospital, Department of General Surgery and Transplantation, Antalya, Turkey.
A
A
Kaya Furkan
Medical Park Hospital, Department of General Surgery and Transplantation, Antalya, Turkey.
M
M
Aslan Sezer
Medical Park Hospital, Department of General Surgery and Transplantation, Antalya, Turkey.
A
A
Demirbas
Medical Park Hospital, Department of Nephrology and Transplantation, Antalya, Turkey.
Y H
YH
Asuman
D020878:Device Removal; D005260:Female; D006801:Humans; D015994:Incidence; D016030:Kidney Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D011184:Postoperative Period; D015607:Stents; D014513:Ureter / Q000601:surgery