Lugmayr H F, Pauer W
Department of Radiology, St Franziskus Hospital, Grieskirchen, Austria.
Radiology. 1996 Jan;198(1):105-8. doi: 10.1148/radiology.198.1.8539359.
To test the clinical efficacy of metal stents in the treatment of malignant ureteral obstruction and to maximize the effectiveness of the method.
Fifty-four malignant stenoses of the ureter were treated in 40 patients by implantation of a self-expandable permanent endoluminal stent (SPES).
The mean follow-up time was 10.5 months (range, 1-44 months). Recanalization was possible in all but one ureter. Fifty-one ureters were kept sufficiently open during the follow-up period. Fifty-one percent needed no further intervention, whereas 49% needed reintervention to reestablish patency. Three ureters in the latter group finally had to be abandoned. The primary patency after 12 months was 31% according to the Kaplan-Meier estimation. The survival rates of the patients were 40% after 12 months and 22% after 24 months and were unrelated to stent placement.
Since no major complications occurred and hydronephrosis and its sequelae could be prevented in most cases during the observation period, the authors conclude that the implantation of a SPES into the ureter is a safe and effective method for the palliative treatment of tumor-associated ureteral strictures.
测试金属支架治疗恶性输尿管梗阻的临床疗效，并使该方法的有效性最大化。
40例患者的54处输尿管恶性狭窄采用自膨式永久性腔内支架（SPES）植入治疗。
平均随访时间为10.5个月（范围1 - 44个月）。除1处输尿管外，其余均实现再通。51处输尿管在随访期间保持充分通畅。51%的患者无需进一步干预，而49%的患者需要再次干预以重建通畅。后一组中的3处输尿管最终不得不放弃。根据Kaplan - Meier估计，12个月后的初始通畅率为31%。患者12个月后的生存率为40%，24个月后的生存率为22%，且与支架置入无关。
由于在观察期内未发生重大并发症，且大多数情况下可预防肾积水及其后遗症，作者得出结论，将SPES植入输尿管是姑息治疗肿瘤相关性输尿管狭窄的一种安全有效的方法。
