双J管联合坦索罗辛在盆腔肿瘤治疗中预防输尿管副损伤的意义

目的 探讨双J管联合坦索罗辛在盆腔肿瘤治疗中预防输尿管副损伤的应用意义.方法 选取2010年10月至2019年9月佛山市三水区人民医院盆腔肿瘤手术病人404例,分为预置管组120例,未置管组246例,单纯口服坦索罗辛组38例.预置管组术前膀胱镜下输尿管逆行插管留置双J管并保留至术后盆腔放疗结束,联合口服坦索罗辛缓释胶囊...

Application of double J tube combined with tamsulosin in the prevention of ureteral injury in the treatment of pelvic tumor

Objective To explore the clinical significance of double-J tube combined with tamsulosin in the prevention of ureteral injury in the treatment of pelvic tumor.Methods A total of 404 patients undergoing pelvic tumor surgery in Sanshui District People''sHospital of Foshan City from October 2010 to September 2019 were selected. The patients were assigned into preset tube group (n = 120), non-tube group (n = 246) and oral tamsulosin group (n = 38). In the preset tube group, double-J tube was indwelling through retrograde ureteral intubation under cystoscope before operation and double-J tube was retained until the end of postoperative pelvic radiotherapy, combined with oral tamsulosin sustained-release capsule. There was no double-J tube in the group without catheterization. In the tamsulosin group, tamsulosin sustained-release capsules were taken after pelvic tumor surgery. The clinical data, intraoperative ureteral injury and postoperative radiotherapy complications of the three groups were compared.Results There were 2 (1.67%) cases of ureteral injury in the preset tube group and 13 (5.28%) cases of ureteral injury in the non-catheterized group, and the difference of injury rate between the two groups was statistically significant (P < 0.05). After postoperative radiotherapy in the three groups, 2 of 89 patients (2.25%) in the preset tube group, 22 of 162 patients (13.58%) in the non-tube group, and 6 of 38 patients (15.79%) in the orallyadministered tamsulosin group developed ureteral stricture resulting in renal function impairment. The incidence of postoperative radiotherapy complications in the preset tube group was compared with that in the other two groups. The difference was statistically significant (P < 0.05).Conclusion Combined use of double-J tube tamsulosin in pelvic tumor surgery has important significance to improvethe identification of ureter, reduce ureteral injury and postoperative ureteral fibrosis stenosis, reduce the risk of renal function injury caused by radioactive ureteral stenosis, reduce the symptoms of urinary tract irritation caused by indwelling double-J tube, promote the recovery of ureteral injury, and protect renal function.