Chow Po-Ming, Hsu Jui-Shan, Wang Shuo-Meng, Yu Hong-Jheng, Pu Yeong-Shiau, Liu Kao-Lang
Department of Urology, National Taiwan University Hospital, National Taiwan University College of Medicine, No.1, Changde St., Zhongzheng Dist., 10048, Taipei, Taiwan.
World J Urol. 2014 Jun;32(3):729-36. doi: 10.1007/s00345-013-1143-y. Epub 2013 Aug 10.
To provide short-term result of the metallic ureteral stent in patients with malignant ureteral obstruction and identify radiological findings predicting stent failure.
The records of all patients with non-urological malignant diseases who have received metallic ureteral stents from July 2009 to March 2012 for ureteral obstruction were reviewed. Stent failure was detected by clinical symptoms and imaging studies. Survival analysis was used to estimate patency rates and factors predicting stent failure.
A total of 74 patients with 130 attempts of stent insertion were included. A total of 113 (86.9 %) stents were inserted successfully and 103 (91.2 %) achieved primary patency. After excluding cases without sufficient imaging data, 94 stents were included in the survival analysis. The median functional duration of the 94 stents was 6.2 months (range 3-476 days). Obstruction in abdominal ureter (p = 0.0279) and lymphatic metastasis around ureter (p = 0.0398) were risk factors for stent failure. The median functional durations of the stents for abdominal and pelvic obstructions were 4.5 months (range 3-263 days) and 6.5 months (range 4-476 days), respectively. The median durations of the stents with and without lymphatic metastasis were 5.3 months (range 4-398 days) and 7.8 months (range 31-476 days), respectively.
Metallic ureteral stents are effective and safe in relieving ureteral obstructions resulting from non-urological malignancies, and abdominal ureteral obstruction and lymphatic metastasis around ureter were associated with shorter functional duration.
提供金属输尿管支架治疗恶性输尿管梗阻患者的短期结果,并确定预测支架失败的影像学表现。
回顾了2009年7月至2012年3月期间因输尿管梗阻接受金属输尿管支架治疗的所有非泌尿生殖系统恶性疾病患者的记录。通过临床症状和影像学检查检测支架失败情况。采用生存分析评估通畅率及预测支架失败的因素。
共纳入74例患者,进行了130次支架置入尝试。共成功置入113枚(86.9%)支架,其中103枚(91.2%)实现了初始通畅。排除影像学数据不足的病例后,94枚支架纳入生存分析。94枚支架的中位功能持续时间为6.2个月(范围3 - 476天)。腹段输尿管梗阻(p = 0.0279)和输尿管周围淋巴结转移(p = 0.0398)是支架失败的危险因素。腹段和盆腔梗阻支架的中位功能持续时间分别为4.5个月(范围3 - 263天)和6.5个月(范围4 - 476天)。有和无淋巴结转移的支架中位持续时间分别为5.3个月(范围4 - 398天)和7.8个月(范围31 - 476天)。
金属输尿管支架在缓解非泌尿生殖系统恶性肿瘤所致输尿管梗阻方面有效且安全,腹段输尿管梗阻和输尿管周围淋巴结转移与较短的功能持续时间相关。