Application of self-expandable metal stents for ureteroileal anastomotic strictures: long-term results
| Autor: | Konstantinos Katsanos, Evangelos Liatsikos, Constantinos Constantinides, Dimitrios Siablis, Zafiria G Papathanassiou, Dimitrios Karnabatidis, George Nikiforidis, Petros Perimenis, George C. Kagadis, Jens-Uwe Stolzenburg |
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| Rok vydání: | 2006 |
| Předmět: |
Male
medicine.medical_specialty Urology medicine.medical_treatment Constriction Pathologic Anastomosis Urinary Diversion Catheterization Stoma Surgical anastomosis Ureter medicine Humans Ureteral Diseases Aged Catheter insertion business.industry Urinary diversion Anastomosis Surgical Stent Surgery medicine.anatomical_structure Treatment Outcome Retreatment Ureteral Stricture Female Stents Radiology business |
| Zdroj: | The Journal of urology. 178(1) |
| ISSN: | 0022-5347 |
| Popis: | We report our long-term experience with the management of benign ureteroileal anastomotic strictures using self-expandable metal stents.A total of 16 male and 2 female patients with a mean+/-SD age of 72+/-7 years (range 66 to 78) with benign fibrotic strictures at the site of ureteroileal anastomosis underwent implantation of self-expandable metal stents with a nominal diameter of 6 to 8 mm. A total of 24 ureteroileal conduits were treated. The external nephrostomy tubes were removed after fluoroscopic validation of ureteral patency. Patients were followed with blood biochemistry, ultrasonography, urography and/or virtual endoscopy. Retrograde external-internal catheter insertion through the cutaneous stoma was performed in cases of recalcitrant stricture.The technical success rate of ureteroileal stricture crossing and stenting was 100% (24 of 24 cases). Mean followup was 21 months (range 7 to 50). The clinical success rate during the immediate post-stenting period was 70.8% (17 of 24 cases). The 1 and 4-year primary patency rates were 37.8% and 22.7%, respectively. Secondary interventions included repeat balloon dilation in 15 ureters, of which 8 also underwent subsequent coaxial stent placement. The 1 and 4-year secondary patency rates were 64.8% and 56.7%, respectively. Except in 2 patients who died external-internal Double-J catheters continued to be inserted retrograde in 6 ureteroileal conduits. They are periodically exchanged to prevent mucous inspissation and stent encrustation.Metal stents served as the definitive treatment for stricture in more than half of the cases, whereas in the remainder the stents allowed the uncomplicated and regular exchange of Double-J catheters in retrograde fashion. This combined, less invasive treatment for ureteroileal anastomotic strictures may help patients avoid surgical revision and preserve quality of life. |
| Databáze: | OpenAIRE |
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