Risk factors of re-obstruction after extravesical ureteral reimplantation
Objective To study the independent risk factors of re-obstruction after ureteral bladder replantation.Methods The clinical data and postoperative follow-up data of 235 patients who underwent ureteral bladder replantation in the Department of Urology of the First Affiliated Hospital of Zhengzhou University from May 2015 to April 2020 were analyzed retrospectively.There were 126 males and 109 fe-males,aged(24.71±8.93)years.According to the occurrence of re-obstruction wwithin 24 months after operation,the patients were divided into two groups:re-obstruction group(n=21)and non-re-obstruction group(n=214).The case data of the two groups were analyzed by univariate and multivariate logistic re-gression.Results Univariate analysis showed that the incidence of re-obstruction in the laparoscopic sur-gery group was higher than that in the robot-assisted laparoscopic surgery group[12.41％(18/145)vs.3.33％(3/90),x2=5.63,P＜0.05].The amount of intraoperative blood loss in the recurrent obstruc-tion group was greater than that in the non-recurrent obstruction group[(297.60±136.00)ml vs.(232.80±99.28)ml,t=2.76,P＜0.01].The postoperative drainage volume in the recurrent obstruc-tion group was greater than that in the non-recurrent obstruction group[(854.50±198.30)ml vs.(560.40±133.70)ml,P＜0.01].The postoperative infection rate in the re-obstruction group was higher than that in the non-re-obstruction group[61.90％(13/21)vs.5.14％(11/214),x2=67.20,P＜0.01].The duration of gross hematuria in the recurrent obstruction group was longer than that in the non-recurrent obstruction group[(11.05±2.22)days vs.(9.43±1.76)days,t=3.91,P＜0.01].There was no significant difference in age,sex,BMI,preoperative ureteral dilatation diameter and operation time between the two groups.Multivariate analysis showed that postoperative drainage[odds ratio(OR)=1.005,95％confidence interval(CI):1.005～1.018,P＜0.01)and postoperative duration of gross hematuria(OR=1.708,95％CI:1.195～2.678,P＜0.01)were independent risk factors for re-obstruc-tion after ureteral bladder replantation.Conclusion Postoperative drainage and postoperative duration of gross hematuria are independent risk factors for re-obstruction after ureteral bladder replantation.
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