Klarskov Peter, Nordling Jørgen, Nielsen John Bugge
Department of Urology, Glostrup Hospital, Glostrup, Denmark.
Scand J Urol Nephrol. 2005;39(2):169-72. doi: 10.1080/00365590510007720.
The Memokath 051 is a thermo-expandable titanium-nickel spiral developed for long-term ureteral stenting. The aim of this study was to investigate the drainage and safety aspects of this stent.
A total of 3-4 consecutive patients were included: 22 had benign strictures, five had post-irradiation strictures and seven had malignant strictures. Follow-up visits took place after 1 month and thereafter every 3 months for at least 1 year.
Thirty-three patients had a total of 37 stents inserted uni- or bilaterally. Pre-insertion dilatation was impossible in one patient and difficult in two, all of whom had post-irradiation strictures. Insertion was complicated in seven patients and uneventful in the other 26. Fifteen stents were in place and functioning with no discomfort or complications at death or the end of follow-up (median 14 months; range 3-30 months), while 22 were non-functioning after 1 day to 16 months (median 5 months). Of these 22 stents, 10 had migrated and 12 were malfunctioning. Among the latter, stricture length was underestimated in four patients, and the stents were replaced successfully shortly after insertion. Four stents were occluded by stones after 1-10 months. No tissue ingrowth was seen. Stent removal was easy, with the exception of one patient with stent calcification.
The Memokath 051 is an alternative for selected patients with non-curable ureteral obstruction but is not suitable for use in patients with functional stenosis or stone formation. Insertion and removal are easy in most patients, but can be difficult or impossible, especially in patients with post-irradiation strictures and retroperitoneal fibrosis. Migration and obstruction can occur and careful follow-up is necessary.
Memokath 051是一种为长期输尿管支架置入而研发的热膨胀性钛镍螺旋管。本研究旨在探讨该支架的引流情况及安全性。
共纳入34例连续患者：22例为良性狭窄，5例为放疗后狭窄，7例为恶性狭窄。术后1个月进行随访，此后每3个月随访一次，至少随访1年。
33例患者共置入37枚支架，单侧或双侧置入。1例患者术前无法进行扩张，2例患者扩张困难，这3例患者均为放疗后狭窄。7例患者置入过程复杂，其余26例患者置入过程顺利。15枚支架在随访结束或患者死亡时（中位时间14个月；范围3 - 30个月）仍在位且功能良好，无不适或并发症，而22枚支架在1天至16个月（中位时间5个月）后失去功能。在这22枚失功能的支架中，10枚发生移位，12枚出现功能障碍。在出现功能障碍的支架中，4例患者的狭窄长度被低估，支架置入后不久即成功更换。4枚支架在1 - 10个月后被结石堵塞。未见组织长入。除1例支架钙化患者外，支架取出均较容易。
Memokath 051是治疗不可治愈性输尿管梗阻患者的一种选择，但不适用于功能性狭窄或结石形成的患者。大多数患者置入和取出操作容易，但在某些患者中可能困难甚至无法进行，尤其是放疗后狭窄和腹膜后纤维化患者。支架可能发生移位和梗阻，因此需要仔细随访。
