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应用共振金属支架治疗输尿管梗阻。

Application of resonance metallic stents for ureteral obstruction.

机构信息

Departments of Urology, Chang Gung Memorial Hospital Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan.

出版信息

BJU Int. 2011 Aug;108(3):428-32. doi: 10.1111/j.1464-410X.2010.09842.x. Epub 2010 Nov 9.

Abstract

OBJECTIVE

• To determine the effectiveness of the Resonance ureteral stent and clarify the risk factors that lead to stent failure. In the present study, we review our clinical experiences using Resonance stent in treating malignant and benign ureteral obstruction.

PATIENTS AND METHODS

• Nineteen patients with extrinsic malignant ureteral obstruction (n= 15) and benign stricture (n= 4) were retrospectively evaluated. • All patients had received Resonance stent insertion through antegrade or cystoscopic retrograde approaches. The pre-insertion and follow-up interventions included image studies and biochemical tests. The insertion success rate, obstruction patency rate and complications were reviewed. • For categorical variables, the chi-square test and Fisher's exact test were carried out to determine associations between variables.

RESULTS

• The technical success rate of stent insertion was 84.6%. The mean follow-up was 5 months (range 1-10.5 months). • Five stents failed to alleviate the obstruction, and the patency rate was 77.3% (17/22). • Patients who had had previous radiation therapy had a lower ureter patency rate in comparison with non-radiation patients (50% vs 92.3% respectively, P= 0.039). • The 6- and 9-month patency rates were 81.0% with 11 stents and 27.0% with 3 stents, respectively.

CONCLUSIONS

• The results of the present study demonstrated that malignant or benign ureteral obstruction could be treated safely and sufficiently with the Resonance metallic stent. • Careful patient selection is critical to achieve successful results. • For malignant ureteral obstruction, previous radiation therapy is a risk factor for stent failure.

摘要

目的

  • 确定 Resonance 输尿管支架的有效性,并阐明导致支架失败的风险因素。本研究回顾了我们使用 Resonance 支架治疗恶性和良性输尿管梗阻的临床经验。

方法

  • 对 19 例因外生恶性输尿管梗阻(n=15)和良性狭窄(n=4)而接受 Resonance 支架置入术的患者进行回顾性评估。

  • 所有患者均经顺行或膀胱镜逆行途径置入 Resonance 支架。置入前和随访干预包括影像学研究和生化检查。评估了置入成功率、梗阻通畅率和并发症。

  • 对于分类变量,采用卡方检验和 Fisher 确切检验来确定变量之间的关联。

结果

  • 支架置入的技术成功率为 84.6%。平均随访时间为 5 个月(范围 1-10.5 个月)。

  • 5 根支架未能缓解梗阻,通畅率为 77.3%(17/22)。

  • 与非放疗患者相比,曾接受过放疗的患者输尿管通畅率较低(分别为 50%和 92.3%,P=0.039)。

  • 11 根支架的 6 个月和 9 个月通畅率分别为 81.0%和 27.0%,3 根支架分别为 81.0%和 27.0%。

结论

  • 本研究结果表明,Resonance 金属支架可安全有效地治疗恶性或良性输尿管梗阻。

  • 仔细选择患者是取得成功的关键。

  • 对于恶性输尿管梗阻,既往放疗是支架失败的一个危险因素。

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