Lee Chung Un, Choo Seol Ho, Chung Jae Hoon, Han Deok Hyun
Department of Urology, Chung-Ang University Gwangmyeong Hospital, Chung-Ang University College of Medicine, Gwangmyeong, Gyeonggi-do, Republic of Korea.
Department of Urology, Ajou University School of Medicine, Suwon, Korea.
BMC Urol. 2024 Dec 19;24(1):268. doi: 10.1186/s12894-024-01653-y.
This study aimed to investigate initial experiences and outcomes of a retrograde inserted new silicone-covered metallic ureteric stent (Urexel™) for malignant ureteric obstruction.
We retrospectively reviewed the medical records for 12 consecutive patients who underwent Urexel™ stent placement for malignant ureteric obstruction from March 2020 to March 2021. The Urexel™ stent is a segmental metallic ureteric stent composed of a nitinol mesh covered with a silicone membrane. We evaluated the clinical outcomes and complications of this new metallic ureteric stent.
The median age of patients was 61.5 (44-82) years, and the median follow-up was 25.5 (4-37) months. One of the 12 patients underwent bilateral stent insertion, Urexel™ stents were placed in a total of 13 ureteral units. There was no technical failure during stent placement. The median length of obstructions was 9 (1-22) cm. Balloon dilation was necessary in 38.5% (5/13 ureter units) of cases. The 6-month success rate was 83.3%, 1-year success rate was 70%, and estimated success rate was 44.4% at 2-year. Encrustation, migration and hyperplasia were the cause of overall treatment failure in all 6 cases of failure, with median elapsed time to failure of 9.5 (1-30) months. Common complications included persistent pain, acute pyelonephritis, and lower urinary tract symptoms, but they were Clavien-Dindo grade I or II.
In this initial series of novel ureteral silicon-covered metallic mesh stents, Urexel™ provided acceptable success and complication rate in malignant ureteric obstructions.
本研究旨在探讨逆行插入新型硅酮覆盖金属输尿管支架（Urexel™）治疗恶性输尿管梗阻的初步经验和效果。
我们回顾性分析了2020年3月至2021年3月期间连续12例因恶性输尿管梗阻接受Urexel™支架置入术患者的病历。Urexel™支架是一种分段金属输尿管支架，由覆盖硅酮膜的镍钛诺网组成。我们评估了这种新型金属输尿管支架的临床效果和并发症。
患者的中位年龄为61.5（44 - 82）岁，中位随访时间为25.5（4 - 37）个月。12例患者中有1例接受了双侧支架置入，共在13个输尿管单位置入了Urexel™支架。支架置入过程中无技术失败。梗阻的中位长度为9（1 - 22）cm。38.5%（5/13个输尿管单位）的病例需要进行球囊扩张。6个月成功率为83.3%，1年成功率为70%，2年估计成功率为44.4%。在所有6例失败病例中，结壳、移位和增生是总体治疗失败的原因，失败的中位时间为9.5（1 - 30）个月。常见并发症包括持续性疼痛、急性肾盂肾炎和下尿路症状，但均为Clavien-Dindo I级或II级。
在这一系列初步的新型输尿管硅酮覆盖金属网支架中，Urexel™在恶性输尿管梗阻治疗中提供了可接受的成功率和并发症发生率。
