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[输尿管内支架治疗恶性输尿管外梗阻时支架失败的预测因素]

[The Predictive Factors of Stent Failure in the Treatment of Malignant Extrinsc Ureteral Obstruction Using Internal Ureteral Stents].

作者信息

Matsuura Hiroshi, Arase Shigeki, Hori Yasuhide, Tochigi Hiromi

机构信息

The Department of Urology, Mie Prefectual General Medical Center.

Kameyama Nephro-urological Clinic.

出版信息

Hinyokika Kiyo. 2017 Dec;63(12):503-507. doi: 10.14989/ActaUrolJap_63_12_503.

Abstract

In this study, we retrospectively reviewed the experiences at our single institute in the treatment of malignant extrinsic ureteral obstruction (MUO) using ureteral stents to investigate the clinical outcomes and the predictive factors of stent failure. In 52 ureters of 38 patients who had radiologically significant hydronephrosis due to MUO, internal ureteral stents (The BARD(R) INLAY(TM) ureteral stent set) were inserted. The median follow-up interval after the initial stent insertion was 124.5 days (4-1,120). Stent failure occurred in 8 ureters (15.4%) of the 7 patients. The median interval from the first stent insertion to stent failure was 88 days (1-468). A Cox regression multivariate analysis showed that the significant predictors of stent failure were bladder invasion. Based on the possibility of stent failure, the adaptation of the internal ureteral stent placement should be considered especially in a patient with MUO combined with bladder invasion.

摘要

在本研究中,我们回顾性分析了我院单中心使用输尿管支架治疗恶性输尿管外梗阻(MUO)的经验,以研究临床结局及支架失败的预测因素。对38例因MUO导致影像学上显著肾积水的患者的52条输尿管置入了输尿管内支架(巴德(BARD)内嵌式(INLAY)输尿管支架套件)。首次置入支架后的中位随访时间为124.5天(4 - 1120天)。7例患者的8条输尿管(15.4%)出现支架失败。从首次置入支架到支架失败的中位间隔时间为88天(1 - 468天)。Cox回归多因素分析显示,支架失败的显著预测因素是膀胱侵犯。基于支架失败的可能性,尤其对于合并膀胱侵犯的MUO患者,应考虑输尿管内支架置入的适应性。

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