Barbalias G A, Siablis D, Liatsikos E N, Karnabatidis D, Yarmenitis S, Bouropoulos K, Dimopoulos J
Department of Urology, University of Patras, School of Medicine, Greece.
J Urol. 1997 Jul;158(1):54-8. doi: 10.1097/00005392-199707000-00015.
We report our experience with the use of metallic self-expandable and balloon expandable stents for the treatment of malignant ureteral obstruction.
We treated 12 consecutive patients with malignant ureteral obstruction, for a total of 14 ureters with stents placed. We placed metallic balloon expandable stents in 6 patients and self-expandable metallic stents in the remaining 6. Mean patient age was 65 years and mean followup was 9 months (range 8 to 16).
Of the ureters 11 were patent without any additional manipulations during followup of 8 to 16 months. Secondary interventions were needed in 3 cases because of obstructive urothelial hyperplastic reaction, tumor ingrowth and local recurrence of the primary cancer invading the upper end of the stent. Two patients died 2 and 10 months after placement of the stent.
Both types of metal stents have advantages and disadvantages that must be balanced against each other when choosing the ideal device for the treatment of obstruction. Implantation of a metal self-expanding or balloon expanding stent is safe and effective for the palliative treatment of malignant ureteral obstruction in late stage cancer patients.
我们报告使用金属自膨式和球囊扩张式支架治疗恶性输尿管梗阻的经验。
我们连续治疗了12例恶性输尿管梗阻患者，共置入14个输尿管支架。6例患者置入金属球囊扩张式支架，其余6例置入自膨式金属支架。患者平均年龄65岁，平均随访9个月（范围8至16个月）。
在8至16个月的随访期间，11个输尿管通畅，无需任何额外操作。3例因梗阻性尿路上皮增生反应、肿瘤长入及原发癌侵犯支架上端局部复发而需要二次干预。2例患者在置入支架后2个月和10个月死亡。
两种类型的金属支架都有优缺点，在选择治疗梗阻的理想装置时必须相互权衡。植入金属自膨式或球囊扩张式支架对晚期癌症患者恶性输尿管梗阻的姑息治疗是安全有效的。
