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Memokath治疗肾肿物冷冻消融术后输尿管狭窄:罕见并发症病例报告及替代治疗方案建议

Memokath for treating ureteric stricture post cryoablation of renal mass: A case report of rare complication and proposed alternative management.

作者信息

Khalil Ibrahim A, Younes Nagy, Awad Khalid, Aldeeb Maya, Aboumarzouk Omar M, Al-Rumaihi Khalid, Al-Ansari Abdulla

机构信息

Department of Urology, Hamad Medical Corporation, PO Box 3050, Doha, Qatar.

Department of Medical Education, Family Medicine Residency Program, Hamad Medical Corporation, Doha, Qatar.

出版信息

Radiol Case Rep. 2022 Nov 9;18(1):300-305. doi: 10.1016/j.radcr.2022.10.033. eCollection 2023 Jan.

Abstract

The use of cryoablation in the management of small renal masses is widely acceptable. Although rare but ureteral injury during the procedure with subsequent stricture formation can result in devastating effects on renal function. On the other hand, the management of such strictures requires reconstructive surgery as gold standard. Unfortunately, in some cases the reconstructive surgery might not be feasible, and the treatment usually is ureteral stent insertion that need to be changed regularly. Here we present a case of a 53-year-old gentleman who developed an upper ureteric iatrogenic stricture post cryoablation in which the reconstructive surgery was not feasible due to high procedural risk. We used metallic ureteral stent (Memokath) instead of regular ureteral double J stent. We found that if the reconstructive surgery is not possible the usage of Memokath in treating iatrogenic ureteral strictures is associated with better quality of life, lower costs and a similar functional outcome when compared to ureteral double J stent that needs regular frequent changes.

摘要

冷冻消融术用于治疗小肾肿块已被广泛接受。尽管手术过程中输尿管损伤并随后形成狭窄的情况罕见,但可能会对肾功能造成毁灭性影响。另一方面,此类狭窄的治疗以重建手术为金标准。不幸的是,在某些情况下重建手术可能不可行,通常的治疗方法是插入输尿管支架且需要定期更换。在此,我们报告一例53岁男性患者,其在冷冻消融术后发生了上段输尿管医源性狭窄,由于手术风险高,重建手术不可行。我们使用了金属输尿管支架(Memokath)而非常规的输尿管双J支架。我们发现,如果重建手术无法进行,与需要经常定期更换的输尿管双J支架相比,使用Memokath治疗医源性输尿管狭窄可带来更好的生活质量、更低的成本以及相似的功能结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b9e/9649948/8cfdb18cb478/gr1.jpg

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