Qing Jing, Hu Ke, Zhang Xuan, Luo Huaming, Chen Jiangchuan, Li Changlong, Zhang Jiamo
Department of Urology, Yongchuan Hospital, Chongqing Medical University, Chongqing, China.
Front Surg. 2024 Nov 19;11:1445808. doi: 10.3389/fsurg.2024.1445808. eCollection 2024.
Malignant ureteral obstruction (MUO) has the potential to result in a range of outcomes, including varying degrees of hydronephrosis and renal impairment. Allium covered metal stents have provided a new, highly effective treatment option for MUO. Our objective was to evaluate the safety and efficacy of the Allium covered metallic stent for the treatment of malignant ureteral obstruction.
Clinical data of 29 patients who underwent endoscopic insertion of an Allium ureteral stent between October 2019 and August 2021 at Yongchuan Hospital, affiliated with Chongqing Medical University, were analyzed retrospectively. At one, three, six and 12 months after insertion, serum creatinine was measured, the width of the renal pelvis was rechecked under ultrasound guidance, and the position and shape of the stent were checked by abdominal x-ray. Data on long-term stent patency, incidence of complications, changes in renal function and hydronephrosis grade were collected and analyzed. Ureteral stent symptom questionnaire (USSQ) was administered preoperatively and after six months in 22 patients with previous stent history.
Allium covered metal stents ( = 33) were implanted successfully in 29 patients who were followed for three to 22 months, with 32/33 stents remaining patent. Serum creatinine levels decreased in 17 patients ( < 0.001), and hydronephrosis decreased in 24 patients. Clavien-Dindo grade I complications were observed in seven patients, Clavien-Dindo II in one patient, whereas stent displacement and stent encrustation occurred in one patient each (Clavien-Dindo III-IV). USSQ scores had significantly improved six months after stent insertion ( < 0.001).
Allium ureteral stents are a safe and effective treatment option for malignant ureteral obstruction, with good long-term patency, helping to preserve renal function and improve quality of life.
恶性输尿管梗阻（MUO）有可能导致一系列后果，包括不同程度的肾积水和肾功能损害。葱覆盖金属支架为MUO提供了一种新的、高效的治疗选择。我们的目的是评估葱覆盖金属支架治疗恶性输尿管梗阻的安全性和有效性。
回顾性分析2019年10月至2021年8月在重庆医科大学附属永川医院接受内镜下植入葱输尿管支架的29例患者的临床资料。在植入后1个月、3个月、6个月和12个月，测量血清肌酐，在超声引导下复查肾盂宽度，并通过腹部X线检查支架的位置和形态。收集并分析长期支架通畅情况、并发症发生率、肾功能变化和肾积水分级数据。对22例有支架植入史的患者在术前和术后6个月进行输尿管支架症状问卷（USSQ）调查。
29例患者成功植入葱覆盖金属支架（n = 33），随访3至22个月，33枚支架中有32枚保持通畅。17例患者血清肌酐水平下降（P < 0.001），24例患者肾积水减轻。观察到7例患者发生Clavien-Dindo I级并发症，1例患者发生Clavien-Dindo II级并发症，而支架移位和支架结壳各发生1例（Clavien-Dindo III-IV级）。支架植入6个月后USSQ评分显著改善（P < 0.001）。
葱输尿管支架是治疗恶性输尿管梗阻的一种安全有效的选择，具有良好的长期通畅性，有助于保护肾功能并改善生活质量。
