Miernik Arkadiusz, Suarez-Ibarrola Rodrigo, Bourdoumis Andreas, Buchholz Noor
Department of Urology, University of Freiburg Medical Center, Faculty of Medicine, Freiburg, Germany.
Department of Urology, Acute Pennine Hospitals NHS Trust, Manchester, United Kingdom.
Urol Int. 2018;101(3):313-319. doi: 10.1159/000492720. Epub 2018 Sep 7.
The study aimed to assess the impact of the Memokath 051 stent (MK) on glomerular filtration rate (GFR) and split renal function in the management of ureteroileal anastomotic strictures.
We treated 6 patients in the ages of 66-77 years, 2 of whom had bilateral strictures, with a total of 8 ureteroileal strictures using the MK stent. Five patients had chronic kidney disease (CKD) prior to MK insertion. Mean time between conduit surgery and MK insertion was 28.4 months. Serum creatinine, GFR, and MAG-3 renography were determined before stent insertion and postoperatively at 3 months.
Postoperative complications at 3-month follow-up included migration in 2 patients, occlusion in 2 patients, and urinary tract infection in 4 patients. The mean stent indwelling time was 353.4 ± 169.3 days. Mean preoperative creatinine, GFR, right, and left split renal function were 158.3 ± 76.3 μmol/L, 43.6 ± 32.9 mL/min/1.73 m2, 52.8 ± 22.2%, and 47.1 ± 22.2%, respectively. Mean postoperative values were 168.1 ± 84 μmol/L (p = 0.84), 40.8 ± 28.4 mL/min/1.73 m2 (p = 0.56), 51.1 ± 18.3% (p = 1), and 48.8 ± 18.3% (p = 1), respectively.
MK stent is a safe and efficient minimally invasive long-term treatment option to preserve GFR in patients who develop CKD through ureteroileal anastomotic stricture. In spite of MK stent insertion and alleviation of obstruction, it was presumably inserted too late to improve renal function.
本研究旨在评估Memokath 051支架（MK）在输尿管回肠吻合口狭窄管理中对肾小球滤过率（GFR）和分肾功能的影响。
我们使用MK支架治疗了6例年龄在66 - 77岁的患者，其中2例为双侧狭窄，共有8处输尿管回肠狭窄。5例患者在插入MK支架前患有慢性肾脏病（CKD）。导管手术与MK支架插入之间的平均时间为28.4个月。在支架插入前及术后3个月测定血清肌酐、GFR和MAG - 3肾图。
3个月随访时的术后并发症包括2例支架移位、2例堵塞和4例尿路感染。支架平均留置时间为353.4±169.3天。术前肌酐、GFR、右侧和左侧分肾功能的平均值分别为158.3±76.3μmol/L、43.6±32.9 mL/min/1.73 m²、52.8±22.2%和47.1±22.2%。术后平均值分别为168.1±84μmol/L（p = 0.84）、40.8±28.4 mL/min/1.73 m²（p = 0.56）、51.1±18.3%（p = 1）和48.8±18.3%（p = 1）。
MK支架是一种安全有效的微创长期治疗选择，可在因输尿管回肠吻合口狭窄而发生CKD的患者中保留GFR。尽管插入了MK支架并缓解了梗阻，但可能插入时间过晚，未能改善肾功能。
