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节段性热膨胀金属合金支架在恶性输尿管梗阻治疗中的应用:英国单中心经验

Use of a segmental thermoexpandable metal alloy stent in the management of malignant ureteric obstruction: a single centre experience in the UK.

作者信息

Zaman F, Poullis C, Bach C, Moraitis K, Junaid I, Buchholz N, Masood J

机构信息

Endourology and Stone Services, Barts and the London NHS Trust, London, UK.

出版信息

Urol Int. 2011;87(4):405-10. doi: 10.1159/000326081. Epub 2011 Oct 18.

Abstract

INTRODUCTION

The Memokath 051™ is a semipermanent inert metal alloy ureteric stent which can bridge strictures and, compared to double J stents, causes less bladder irritation and pain, is more resistant to external compression forces and may be more effective in patients with malignant ureteric obstruction. We present our experience with this novel stent in such cases.

METHODS

All suitable patients referred to us with malignancy-associated ureteric strictures over a 4-year period had ureteric Memokath 051™ stents inserted. Data on aetiology and position of the strictures as well as length of the Memokath stents used and their efficacy and complications were recorded prospectively.

RESULTS

42 ureteric Memokath 051™ stents were inserted in 37 patients (mean age 64 years). 40.5% of strictures were related to gynaecological cancer, 21% to bowel cancer, 14% were post radiation, 14% occurred in prostate cancer patients and 9.5% were found in other cancers. The mean follow-up was 22 months (range 5-60 months). The main complications were stent migrations in 5, urinary tract infections in 3 and blockage of stent due to progressive transitional cell carcinoma of the ureter in 2 cases.

CONCLUSION

Memokath 051™ ureteric stents are safe, effective and durable in the long-term treatment of malignant strictures.

摘要

引言

Memokath 051™是一种半永久性惰性金属合金输尿管支架,可跨越狭窄部位,与双J支架相比,它对膀胱的刺激和疼痛较小,对外界压力更具抵抗力,可能对恶性输尿管梗阻患者更有效。我们在此介绍我们在这类病例中使用这种新型支架的经验。

方法

在4年期间,所有因恶性肿瘤相关输尿管狭窄转诊至我们科室的合适患者均植入了输尿管Memokath 051™支架。前瞻性记录狭窄的病因、位置、所用Memokath支架的长度及其疗效和并发症。

结果

37例患者(平均年龄64岁)共植入42枚输尿管Memokath 051™支架。40.5%的狭窄与妇科癌症有关,21%与肠癌有关,14%为放疗后狭窄,14%发生在前列腺癌患者中,9.5%见于其他癌症。平均随访22个月(范围5 - 60个月)。主要并发症包括5例支架移位、3例尿路感染以及2例因输尿管移行细胞癌进展导致的支架堵塞。

结论

Memokath 051™输尿管支架在恶性狭窄的长期治疗中安全、有效且耐用。

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