Smith P, Bruera E
Palliative Care Program, Edmonton General Hospital, University of Alberta, Canada.
J Pain Symptom Manage. 1995 Aug;10(6):481-6. doi: 10.1016/0885-3924(95)00017-s.
Acute renal failure due to bilateral ureteral obstruction is a common problem in palliative care. We report on two patients with advanced rectosigmold carcinoma in which bilateral malignant ureteral obstruction was managed by pharmacological and endourologic methods, respectively. The first patient showed excellent response to high-dose corticosteroids. The second patient showed no evidence of response and a urinary diversion procedure was performed. Indications for both pharmacological and endourological interventions in these patients are discussed. Our findings suggest that decision regarding the management of ureteral obstruction needs to be highly personalized and follow careful discussion with the patient and/or family.
双侧输尿管梗阻所致急性肾衰竭是姑息治疗中的常见问题。我们报告了两名患有晚期直肠乙状结肠癌的患者，其中双侧恶性输尿管梗阻分别通过药物和腔内泌尿外科方法进行处理。第一名患者对大剂量皮质类固醇表现出良好反应。第二名患者未显示出反应迹象，遂进行了尿流改道术。讨论了对这些患者进行药物和腔内泌尿外科干预的指征。我们的研究结果表明，关于输尿管梗阻处理的决策需要高度个体化，并在与患者和/或家属仔细讨论后做出。
