Berent Allyson C, Weisse Chick, Beal Matthew W, Brown Dorothy C, Todd Kimberly, Bagley Demetrius
The Matthew J. Ryan Veterinary Hospital, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
J Am Vet Med Assoc. 2011 Apr 15;238(8):1017-25. doi: 10.2460/javma.238.8.1017.
To determine the outcome of minimally invasive ureteral stent placement for dogs with malignant ureteral obstructions. DESIGN-Retrospective case series.
12 dogs (15 ureters) with ureteral obstruction secondary to a trigonal urothelial carcinoma.
In all patients, indwelling, double-pigtail ureteral stents were placed by means of percutaneous antegrade needle and guide wire access under ultrasound and fluoroscopic guidance.
Stents were successfully placed in all patients. In 11 of 12 patients, percutaneous antegrade access was accomplished. One patient required access via laparotomy because percutaneous access could not be achieved. The median survival time from the date of diagnosis was 285 days (range, 10 to 1,571 days), with a median survival time of 57 days (range, 7 to 337 days) from the date of stent placement. Three complications occurred in 1 patient. Seven patients required concurrent urethral stent placement for relief of urethral obstruction. All animals were discharged from the hospital (median hospitalization time after stent placement, 18 hours [range, 4 hours to 7 days]) with an indwelling, double-pigtail ureteral stent (3 bilateral and 9 unilateral) in place. All stents evaluated 0.25 to 11 months after placement were considered patent.
Findings suggested that ureteral stent placement was safe, effective, and well tolerated in patients with malignant ureteral obstructions. Stents could be reliably placed in a minimally invasive manner and remain patent long-term. Ureteral stent placement should be considered as early as possible in patients with neoplasia, prior to the development of permanent renal damage.
确定微创输尿管支架置入术治疗犬恶性输尿管梗阻的疗效。设计——回顾性病例系列研究。
12只犬（15条输尿管），患有继发于三角区尿路上皮癌的输尿管梗阻。
所有患者均在超声和荧光透视引导下，通过经皮顺行穿刺针和导丝通路置入双猪尾输尿管留置支架。
所有患者均成功置入支架。12例患者中有11例成功完成经皮顺行通路建立。1例患者因无法实现经皮通路而需要通过剖腹手术建立通路。从诊断日期起的中位生存时间为285天（范围为10至1571天），从支架置入日期起的中位生存时间为57天（范围为7至337天）。1例患者发生3例并发症。7例患者需要同时置入尿道支架以缓解尿道梗阻。所有动物均出院（支架置入后的中位住院时间为18小时[范围为4小时至7天]），体内留置双猪尾输尿管支架（3例双侧，9例单侧）。所有在置入后0.25至11个月评估的支架均被认为通畅。
研究结果表明，输尿管支架置入术对于恶性输尿管梗阻患者是安全、有效的，且耐受性良好。支架可以通过微创方式可靠地置入并长期保持通畅。对于患有肿瘤的患者，应在永久性肾损伤发生之前尽早考虑输尿管支架置入术。
