膀胱癌患者在根治性膀胱切除术 (RC) 之前使用双 J 支架 (DJ) 是否会增加上尿路肿瘤种植的风险，从而增加异时性上尿路尿路上皮癌 (UTUC) 的风险，这一点存在争议。我们的研究目的是调查既往接受 DJ 支架治疗的患者 RC 后上尿路复发的风险。本研究纳入了 2003 年 1 月至 2022 年 3 月期间接受 RC 且具有完整围手术期数据和病理结果的 699 例患者。我们的研究。确定术前接受 DJ 支架治疗的患者，并将其与先前未接受内部支架植入的患者进行比较，以了解异时性 UTUC 的发生情况。使用多变量 Cox 回归分析来确定可能的病理特征中 UTUC 发生的预测因素；还检查了 RC 后死亡的危险因素。在 699 名患者中，117 名 (16.7%) 术前接受了 DJ 支架治疗。 1 年、3 年和 5 年异时 UTUC 的总体概率分别为 1%、4% 和 6%。除了 DJ 组肾积水发生率较高之外，接受和不接受 DJ 支架置入术的组的临床病理特征具有可比性。在相似的随访期间（中位随访 32 个月），DJ 组中有 4 名患者（3.4%）检测到异时性 UTUC，无支架组有 13 名患者（2.2%）检测到异时性 UTUC（P=0.44）。 DJ 组从膀胱切除术到 UTUC 的中位间隔 (IQR) 为 40.5 (20-49) 个月，无支架组为 37 (24-82) 个月 (P=0.7)。在多变量分析中，仅存在 CIS（HR 3.83，95% CI 1.19-12.29，P=0.024）和输尿管切缘阳性（HR=5.2，95% CI 1.38-19.57，P=0.015）是异时性 UTUC 的预测因素。该研究受到回顾性性质和相对较短的随访的限制。输尿管支架置入术治疗接受 RC 的膀胱癌患者的肾积水是一种可行的选择，且没有较高的 UTUC 或死亡风险。输尿管切缘阳性和CIS的患者被认为是上尿路复发的高危人群，应接受长期、严格的随访。

It is controversial whether the use of a double-J stent (DJ) in patients with bladder cancer before radical cystectomy (RC) increases the risk of tumour seeding in the upper tract and thus the risk of metachronous upper tract urothelial carcinoma (UTUC). The aim of our study is to investigate the risk of upper tract recurrence after RC in patients previously managed with a DJ stent.A total of 699 patients who had undergone RC between January 2003 and March 2022 with complete perioperative data and pathological outcome were included in our study. Patients treated preoperatively with a DJ stent were identified and compared for development of metachronous UTUC with those who did not receive prior internal stenting. Multivariable Cox regression analysis was used to determine predictors of UTUC occurrence among the possible pathological features; risk factors for mortality after RC were also examined.Of 699 patients, 117 (16.7%) were managed preoperatively with a DJ stent. The overall probability of metachronous UTUC was 1%, 4% and 6% at 1, 3 and 5 years, respectively. The groups with and without DJ stenting were comparable regarding their clinicopathologic features, except for the higher incidence of hydronephrosis in the DJ group. At similar follow-up periods (median follow-up 32 months), metachronous UTUC was detected in four (3.4%) patients in the DJ group and in 13 (2.2%) in the non-stented group (P=0.44). The median interval (IQR) from cystectomy to UTUC was 40.5 (20-49) months in the DJ group and 37 (24-82) in the non-stented group (P=0.7). In the multivariable analysis, only presence of CIS (HR 3.83, 95% CI 1.19-12.29, P=0.024) and positive ureteral margin (HR=5.2, 95% CI 1.38-19.57, P=0.015) were predictors of metachronous UTUC. The study is limited by the retrospective nature and relatively short follow-up.Ureteral stenting for management of hydronephrosis in patients with bladder cancer undergoing RC is a viable option, without higher risk for UTUC or mortality. Patients with positive ureteral margin and CIS are considered high-risk groups for upper tract recurrence and should receive long-term, rigorous follow-up.