Haroon Ahmed, Younes Nagy, El-Sayid Khalid, Khatib Malkan, Khalil Ibrahim A, Ahmad Jamil, Abomarzouk Omar M, Al-Rumaihi Khalid, Al-Ansari Abdulla
Department of Urology, Hamad Medical Corporation, Doha, Qatar.
Department of Surgery, Surgical Research Section, Hamad Medical Hospital, Hamad Medical Corporation, Doha, Qatar.
Radiol Case Rep. 2024 Jun 22;19(9):3829-3832. doi: 10.1016/j.radcr.2024.05.072. eCollection 2024 Sep.
Robotic assisted partial nephrectomy is the gold standard treatment for small renal masses. Ureteric stricture is a rare but serious complication that significantly increase the morbidity and worsens the quality of life for cancer patients. Definitive treatment such as surgical reconstruction or ureteroureterostomy is not always feasible as in patients with significant morbidity or high-risk patients. Other options include ureteric double J stent or nephrostomy tube placement with regular exchange. We present a case of iatrogenic upper ureteric stricture post robotic assisted partial nephrectomy for right renal mass that was discovered on postoperative follow up imaging treated with metallic ureteral stent (Memokath) as reconstructive surgery was difficult due to proximity to the tumor bed. We found that if reconstructive surgery is not feasible, metallic ureteral stents has good durability, better quality of life than ureteric double stents for the management of ureteric stricture.
机器人辅助部分肾切除术是治疗小肾肿瘤的金标准。输尿管狭窄是一种罕见但严重的并发症，会显著增加癌症患者的发病率并恶化其生活质量。对于合并严重疾病的患者或高危患者，诸如手术重建或输尿管输尿管吻合术等确定性治疗并不总是可行的。其他选择包括放置输尿管双J支架或定期更换肾造瘘管。我们报告一例因右肾肿瘤行机器人辅助部分肾切除术后发生医源性上段输尿管狭窄的病例，该狭窄在术后随访影像检查中被发现，由于靠近肿瘤床，重建手术困难，遂采用金属输尿管支架（Memokath）进行治疗。我们发现，如果重建手术不可行，金属输尿管支架在治疗输尿管狭窄方面具有良好的耐用性，与输尿管双支架相比能提供更好的生活质量。
