Gao Xiaoshuai, Chen Jixiang, Jian Zhongyu, Wang Menghua, Wang Wei, Peng Liao, Liu Zhenghuan, Wei Xin
Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, China.
Front Surg. 2021 Dec 21;8:765810. doi: 10.3389/fsurg.2021.765810. eCollection 2021.
The aim of this prospective study was to assess the safety and effectiveness of self-expanding metal ureteral stent (MUS) for the treatment of recurrent ureteral stricture after ureteroplasty. We prospectively included 24 patients who underwent MUS implantation between February 2019 and August 2020. The inclusion criteria for the procedure were recurrent ureteral strictures after ureteroplasty. A paired test was used to compare continuous variables before and after surgery. A total of 24 patients were finally included in this study. The stricture site was most common on the proximal ureter 19 (79.2%), followed by distal ureter 4 (16.7%) and middle ureter 1 (4.2%). The median length of ureteral stricture is 2.5 (range 1-18) cm. The median operative time was 51.5 min, and the median hospital stay time after surgery was 3 days. Post-operative complication included pain 1 (4.2%), urinary tract infection 2 (8.3%) and hematuria 2 (8.3%). After a median follow-up of 12 months, 19/24 (83.3%) patients were clinically and radiologically successful. We endoscopically adjusted or exchanged the failed stents. The volume of hydronephrosis (124.7 ± 132.5 vs. 66.4 ± 73.2 cm, = 0.015), blood creatinine level (104.5 ± 45.4 vs. 80.1 ± 23.2 μmol/L, = 0.044) and urea nitrogen level (6.9 ± 2.4 vs. 4.8 ± 1.5 mmol/L, = 0.003) decreased significantly after a median follow-up of 12 months. MUS is a safe and effective way to manage recurrent ureteral strictures after ureteroplasty. This technique provides a new choice for the treatment of recurrent stricture.
这项前瞻性研究的目的是评估自膨式金属输尿管支架（MUS）治疗输尿管成形术后复发性输尿管狭窄的安全性和有效性。我们前瞻性纳入了2019年2月至2020年8月期间接受MUS植入术的24例患者。该手术的纳入标准为输尿管成形术后复发性输尿管狭窄。采用配对检验比较手术前后的连续变量。本研究最终共纳入24例患者。狭窄部位最常见于输尿管上段19例（79.2%），其次为输尿管下段4例（16.7%）和输尿管中段1例（4.2%）。输尿管狭窄的中位长度为2.5（范围1-18）cm。中位手术时间为51.5分钟，术后中位住院时间为3天。术后并发症包括疼痛1例（4.2%）、尿路感染2例（8.3%）和血尿2例（8.3%）。中位随访12个月后，19/24（83.3%）例患者在临床和影像学上取得成功。我们通过内镜调整或更换了失败的支架。中位随访12个月后，肾积水体积（124.7±132.5 vs. 66.4±73.2 cm，P = 0.015）、血肌酐水平（104.5±45.4 vs. 80.1±23.2 μmol/L，P = 0.044）和尿素氮水平（6.9±2.4 vs. 4.8±1.5 mmol/L，P = 0.003）均显著下降。MUS是治疗输尿管成形术后复发性输尿管狭窄的一种安全有效的方法。该技术为复发性狭窄的治疗提供了一种新的选择。
