Analysis of the reasons for the formation of double J tube wall attached stones after ureteroscopic holmium laser lithotripsy for the treatment of complex upper ureteral stones
Han Xiao
Kong Guangqi
Wei Guangzhu
Xian Shaozhong
Cui Shujin
Abstract：Objective:To analyze the causes of encrustation formation on double-J stents after flexible ureteros-copy with holmium lase lithotripsy for the treatment of upper ureteral complex stones.Methods:105 patients with complex upper ureteral stones admitted to Beijing Luhe Hospital Affiliated to Capital Medical University from Janu-ary 2015 to August 2023 were selected,including 58 males and 47 females.According to the evaluation results of the stones,they were divided into stone group(n=40)and no stone group(n=65).Analyze the influencing factors of the formation of double J tube wall attached stones in patients using the random forest algorithm.Analyze the indepen-dent influencing factors of the formation of double J tube wall attached stones through single factor and multiple factor analysis,and construct a classification tree model.Results:There were statistically significant differences between the stone group and the non stone group in CT values,intraoperative blood loss,double J tube retention time,white blood cell count(WBC),C-reactive protein(CRP),uric acid(UA),blood calcium,urine pH,urine protein,urine red blood cells,urine white blood cells,and urine crystallization(t/χ2=4.361,2.502,6.815,12.176,24.398,15.595,6.517,2.069,6.881,4.524,3.883,4.699,respectively,all P<0.05).The duration of double J tube retention,posi-tive urine protein,positive urine crystallization,and UA were independent risk factors for the formation of double J tube wall attached stones(P<0.05).The classification tree model showed that the retention time of double J tubes was an important predictive factor for the formation of double J tube wall attached stones,and the profit and index charts showed that the model predicts well.Conclusion:The duration of double J tube retention,positive urine pro-tein,positive urine crystallization,and UA are independent risk factors for the formation of double J tube wall at-tached stones.Clinical attention should be paid to relevant factors and timely prevention strategies should be formulat-ed to reduce the risk of double J tube wall attached stones.
Keywords：soft mirror holmium laser lithotripsycomplex upper ureteral stonesdouble J tube wall attached stonesprediction model
Publication Date：2024-08-05
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：8( 257-264 )