Daskalopoulos G, Hatzidakis A, Triantafyllou T, Delakas D, Anezinis P, Metaxari M, Cranidis A
Department of Urology, General University Hospital of Heraklion, 71110 Heraklion, Crete,Greece.
Eur J Radiol. 2001 Sep;39(3):194-200. doi: 10.1016/s0720-048x(01)00331-x.
We report our experience on intraureteral metallic stents placement for the treatment of malignant and benign ureteral strictures.
Eight patients (six men and two women) with inoperable malignant or benign ureteral strictures, underwent insertion of metallic stents through percutaneous tracts. Six lesions (three malignant, three benign) involved ureterointestinal anastomoses after cystectomy for bladder cancer and ureteroileal urinary diversion or bladder substitution, and two malignant lesions involved the midureter. Self-expandable stents were used in seven cases and a balloon-expandable stent in the remaining one case. One stent was sufficient in seven ureters, and in one ureter, two overlapping stents were placed.
Metallic stents were inserted without technical difficulties in all obstructed ureters and patency was achieved in all patients. Ultrasonography revealed resolution of pre-existing hydronephrosis. The duration of follow-up was 6-17 months (mean, 9 months). One ureter was occluded 8 months after stent placement because of ingrowth of tumor and granulation tissue. The other ureters showed no signs of obstruction during follow-up. No major complications directly attributable to the metallic stent occurred.
Our results suggest that insertion of a metallic stent in the ureter is feasible and safe for the treatment of benign or malignant ureteral strictures. However, more work needs to be done to establish the use of these stents for the treatment of ureteral obstruction.
我们报告经输尿管金属支架置入治疗恶性和良性输尿管狭窄的经验。
8例（6例男性，2例女性）无法手术的恶性或良性输尿管狭窄患者，通过经皮通道置入金属支架。6例病变（3例恶性，3例良性）发生在膀胱癌膀胱切除术后输尿管肠吻合及输尿管回肠尿流改道或膀胱替代术后，2例恶性病变累及输尿管中段。7例使用自膨式支架，其余1例使用球囊扩张式支架。7条输尿管置入1枚支架即可，1条输尿管置入2枚重叠支架。
所有梗阻输尿管均顺利置入金属支架，所有患者均实现通畅。超声检查显示原有肾积水消退。随访时间为6 - 17个月（平均9个月）。1条输尿管在支架置入8个月后因肿瘤长入和肉芽组织增生而闭塞。其他输尿管在随访期间未出现梗阻迹象。未发生直接归因于金属支架的重大并发症。
我们的结果表明，输尿管内金属支架置入术治疗良性或恶性输尿管狭窄是可行且安全的。然而，要确定这些支架在输尿管梗阻治疗中的应用，还需要做更多工作。
