Thursday 14 march 2019
12:54 - 12:57h
Categories: Klinisch, Postersessie
Parallel session: Postersessies 5 - Clinical
I.J. Visser, J.P.T. van der Staaij, J.A. Lafranca, J.M.F. Dor.
Imperial College Renal and Transplant Centre, Imperial College NHS Healthcare, London,United Kingdom.
Background: Implanting a ureteric stent during ureteroneocystostomy reduces the risk of urinary leakage and ureteral stenosis after kidney transplantation (KTx), but it may also predispose to urinary tract infections (UTI). The aim of this study is to determine a more definite moment for ureteric stent removal after KTx.
Methods: Searches were performed in EMBASE, MEDLINE Ovid, Cochrane CENTRAL, Web of science and Google scholar. All aspects of the Cochrane Handbook for Interventional Systematic Reviews are followed and is written based on the PRISMA-statement. Articles discussing JJ-stents and their time of removal in relation to outcome were included. Studied outcome measures were UTI, urinary leakage, ureteral stenosis and re-intervention.
Results: 1043 articles were identified, of which 14 articles were included. Meta-analysis showed a significant reduction of UTI when stents were removed within three weeks (OR 0.52, p = 0.008). Regarding incidence of urinary leakage, there is no significant difference between early and late stent removal (OR 0,928, p= 0,898). No meta-analysis could be performed on the outcome of ureteral stenosis, because of the lack data.
Conclusions: Based on our results, earlier stent removal after KTx (earlier than 3 weeks) is associated with a decreased incidence of UTI and does not show a higher incidence of urinary leakage compared to later removal (later than 3 weeks). We recommend that the routine removal of ureteric stents implanted during kidney transplantation should be performed around three weeks postoperatively.