https://doi.org/10.4081/aiua.2022.1.12

Does routine intraoperative Double J stent insertion avoid urine leakage after open partial nephrectomy?

Vol. 94 No. 1 (2022)
Submitted: February 5, 2022
Accepted: February 10, 2022
Published: March 28, 2022
Kidney tumor, Double J stent, Urine leakage, Partial nephrectomy
Abstract Views: 1382
PDF: 428
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Authors

Efe Bosnali
https://orcid.org/0000-0002-8412-577X
Kocaeli University, School of Medicine, Department of Urology, Kocaeli, Turkey.
Ozdal Dillioglugil
https://orcid.org/0000-0001-5460-4588
Kocaeli University, School of Medicine, Department of Urology, Kocaeli, Turkey.
Kerem Teke
Kocaeli University, School of Medicine, Department of Urology, Kocaeli, Turkey.
Hasan Yilmaz
Kocaeli University, School of Medicine, Department of Urology, Kocaeli, Turkey.
Busra Yaprak Bayrak
https://orcid.org/0000-0002-0537-3127
Kocaeli University, School of Medicine, Department of Pathology, Kocaeli, Turkey.
Ali Kemal Uslubas
Kocaeli University, School of Medicine, Department of Urology, Kocaeli, Turkey.
Ibrahim Erkut Avci
erkutavci@gmail.com
Kocaeli University, School of Medicine, Department of Urology, Kocaeli, Turkey.
Omer Burak Argun
Acibadem Mehmet Ali Aydinlar University, Department of Urology, School of Medicine, Istanbul, Turkey.
Onder Kara
Kocaeli University, School of Medicine, Department of Urology, Kocaeli, Turkey.

Objective: To evaluate the impact of Double J stent (DJS) insertion during open partial nephrectomy (OPN) on postoperative prolonged urinary leakage.
Materials and methods: A retrospective study was made in consecutive cases of OPN performed between 2002 and 2020 for localized kidney tumors at our tertiary center. Urinary leakage was defined as drainage > 72 hours after surgery by biochemical analysis consistent with urine or radiographic evidence of urine leakage. The patients were divided into two groups according to intraoperative DJS placement, and compared regarding clinicopathologic characteristics, perioperative and postoperative outcomes. Univariate and multivariate logistic regression analyses were performed to determine the factors associated with urinary leakage after the operation.
Results: Review of records identified 182 patients who were included in the study. In 73 (40%) patients PN was performed without insertion of a DJS. Thus, 109 (60%) of patients had a DJS inserted. Apart from higher preoperative eGFR values among patients with DJS (96.6 vs. 94.3 mL/min/1.73 m²; p = 0.03), demographic characteristics were similar between groups. The two groups were not different regarding perioperative, postoperative and clinicopathologic outcomes. Patients with DJS had longer ischemia times (31 vs. 23 min; p = 0.02) and longer length of stay (6 vs. 5 days; p = 0.04). Urinary leakage was seen in 7.6% (n = 14) of all patients and it did not differ according to DJS placement (DJS+ 9.2 vs. DJS- 5.5%; p = 0.41). On multivariate analysis, the tumor nearness to the collecting system was the sole independently significant factor (p = 0.04) predicting postoperative urine leak.
Conclusions: Routine intraoperative DJS insertion during OPN does not appear to reduce the probability of postoperative urine leak.

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Scopus
Google Scholar
Europe PMC
Ljungberg B, Albiges L, Abu-Ghanem Y, et al. European Association of Urology Guidelines on Renal Cell Carcinoma: The 2019 Update. Eur Urol. 2019; 75:799. DOI: https://doi.org/10.1016/j.eururo.2019.02.011
Volpe A, Panzarella T, Rendon RA, et al. The natural history of incidentally detected small renal masses. Cancer. 2004; 100:738. DOI: https://doi.org/10.1002/cncr.20025
Mir MC, Derweesh I, Porpiglia F, et al. Partial nephrectomy versus radical nephrectomy for clinical T1b and T2 renal tumors: a systematic review and meta-analysis of comparative studies. Eur Urol. 2017; 71:606. DOI: https://doi.org/10.1016/j.eururo.2016.08.060
Lesage K, Joniau S, Fransis K, Van Poppel H. Comparison between open partial and radical nephrectomy for renal tumours: perioperative outcome and health-related quality of life. Eur Urol. 2007;51:614. DOI: https://doi.org/10.1016/j.eururo.2006.10.040
Potretzke AM, Knight BA, Zargar H, et al. Urinary fistula after robot-assisted partial nephrectomy: a multicentre analysis of 1 791 patients. BJU Int. 2016; 117:131. DOI: https://doi.org/10.1111/bju.13249
Spana G, Haber GP, Dulabon LM, et al. Complications after robotic partial nephrectomy at centers of excellence: multi-institutional analysis of 450 cases. J Urol. 2011; 186:417. DOI: https://doi.org/10.1016/j.juro.2011.03.127
Zargar H, Khalifeh A, Autorino R, et al. Urine leak in minimally invasive partial nephrectomy: analysis of risk factors and role of intraoperative ureteral catheterization. Int Braz J Urol. 2014; 40:763. DOI: https://doi.org/10.1590/S1677-5538.IBJU.2014.06.07
Bove P, Bhayani SB, Rha KH, et al. Necessity of ureteral catheter during laparoscopic partial nephrectomy. J Urol. 2004; 172:458. DOI: https://doi.org/10.1097/01.ju.0000130332.35800.08
Yoo S, You D, Jeong IG, et al. Does ureteral catheter insertion decrease the risk of urinary leakage after partial nephrectomy in patients with renal cell carcinoma? Clin Genitourin Cancer. 2017; 15:707. DOI: https://doi.org/10.1016/j.clgc.2017.01.023
Clavien PA, Barkun J, de Oliveira ML, et al. The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg. 2009; 250:187. DOI: https://doi.org/10.1097/SLA.0b013e3181b13ca2
Levey AS, Bosch JP, Lewis JB, et al. A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med. 1999; 130:461. DOI: https://doi.org/10.7326/0003-4819-130-6-199903160-00002
Ozkan L, Saribacak A, Taneri C, et al. A new technique-"lipocorticoplasty"-for the closure of partial nephrectomy defects and its comparison with the standard technique. Int Urol Nephrol. 2011;43:737. DOI: https://doi.org/10.1007/s11255-011-9899-8
Chow WH, Devesa SS, Warren JL, Fraumeni JF, Jr. Rising incidence of renal cell cancer in the United States. JAMA. 1999; 281:1628. DOI: https://doi.org/10.1001/jama.281.17.1628
Kim FJ, Rha KH, Hernandez F, et al. Laparoscopic radical versus partial nephrectomy: assessment of complications. J Urol. 2003;170:408. DOI: https://doi.org/10.1097/01.ju.0000076017.26789.6a
Tanagho YS, Kaouk JH, Allaf ME, et al. Perioperative complications of robot-assisted partial nephrectomy: analysis of 886 patients at 5 United States centers. Urology. 2013; 81:573 DOI: https://doi.org/10.1016/j.urology.2012.10.067
Permpongkosol S, Link RE, Su LM, et al. Complications of 2,775 urological laparoscopic procedures: 1993 to 2005. J Urol. 2007;177:580. DOI: https://doi.org/10.1016/j.juro.2006.09.031
Wheat JC, Roberts WW, Hollenbeck BK, et al. Complications of laparoscopic partial nephrectomy. Urol Oncol. 2013; 31:57. DOI: https://doi.org/10.1016/j.urolonc.2010.11.003
Campbell SC, Novick AC, Streem SB, et al. Complications of nephron sparing surgery for renal tumors. J Urol. 1994; 151:1177. DOI: https://doi.org/10.1016/S0022-5347(17)35207-2
Steinbach F, Stockle M, Muller SC, et al. Conservative surgery of renal cell tumors in 140 patients: 21 years of experience. J Urol. 1992; 148:24. DOI: https://doi.org/10.1016/S0022-5347(17)36499-6
Kundu SD, Thompson RH, Kallingal GJ, et al. Urinary fistulae after partial nephrectomy. BJU Int. 2010; 106:1042. DOI: https://doi.org/10.1111/j.1464-410X.2010.09230.x
Minervini A, Vittori G, Antonelli A, et al. Open versus roboticassisted partial nephrectomy: a multicenter comparison study of perioperative results and complications. World J Urol. 2014; 32:287. DOI: https://doi.org/10.1007/s00345-013-1136-x
Meeks JJ, Zhao LC, Navai N, et al. Risk factors and management of urine leaks after partial nephrectomy. J Urol. 2008; 180:2375. DOI: https://doi.org/10.1016/j.juro.2008.08.018
French DB, Marcovich R. Fibrin sealant for retrograde ureteroscopic closure of urine leak after partial nephrectomy. Urology. 2006; 67:1081. DOI: https://doi.org/10.1016/j.urology.2005.11.026
De Concilio B, Vedovo F, Mir MC, et al. Gelatin sponge (Spongostan(R)) and N-butyl-2-cyanoacrylate: Utility on percutaneous treatment of persistent urinary leakage after partial nephrectomy. Case report and review of the literature. Arch Ital Urol Androl. 2020; 92:200 DOI: https://doi.org/10.4081/aiua.2020.3.200
Haber GP, Gill IS. Laparoscopic partial nephrectomy: contemporary technique and outcomes. Eur Urol. 2006; 49:660. DOI: https://doi.org/10.1016/j.eururo.2006.02.001
Kaouk JH, Hillyer SP, Autorino R, et al. 252 robotic partial nephrectomies: evolving renorrhaphy technique and surgical outcomes at a single institution. Urology. 2011; 78:1338. DOI: https://doi.org/10.1016/j.urology.2011.08.007
Gill IS, Desai MM, Kaouk JH, et al. Laparoscopic partial nephrectomy for renal tumor: duplicating open surgical techniques. J Urol. 2002; 167:469 DOI: https://doi.org/10.1097/00005392-200202000-00005
Peyronnet B, Seisen T, Oger E, et al. Comparison of 1800 Robotic and open partial nephrectomies for renal tumors. Ann Surg Oncol. 2016; 23:4277. DOI: https://doi.org/10.1245/s10434-016-5411-0
Ficarra V, Bhayani S, Porter J, et al. Predictors of warm ischemia time and perioperative complications in a multicenter, international series of robot-assisted partial nephrectomy. Eur Urol. 2012; 61:395. DOI: https://doi.org/10.1016/j.eururo.2011.10.046

How to Cite

Bosnali , E., Dillioglugil, O., Teke, K., Yilmaz, H., Yaprak Bayrak, B., Uslubas, A. K., Avci, I. E., Argun, O. B., & Kara, O. (2022). Does routine intraoperative Double J stent insertion avoid urine leakage after open partial nephrectomy?. Archivio Italiano Di Urologia E Andrologia, 94(1), 12–17. https://doi.org/10.4081/aiua.2022.1.12

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