Auto-Expandable Metallic Ureteral Stents for Complex Ureteral Stenosis: Long-Term Outcomes in a Tertiary Institution.

IF 1.5 4区医学 Q3 UROLOGY & NEPHROLOGY

Urologia Internationalis Pub Date : 2025-01-03 DOI:10.1159/000542941

Marina Mata, Inés María Laso-García, Javier Lorca-Álvaro, Gemma Duque-Ruiz, Fernando Arias-Fúnez, Manuel Hevia, Enrique López-Pérez, Francisco Burgos-Revilla

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引用次数: 0

Abstract

Introduction: Auto-expandable ureteral stents can be an alternative to percutaneous nephrostomy (PCN) in refractory ureteral stenosis. Our aim was to analyse results and complications of ureteral stents in our centre.

Methods: Retrospective review of OptiMed® expandable ureteral stents placed in our centre (1996-2022). Analysis of complications (Clavien-Dindo classification) was performed. Kaplan-Meier curves (long-rank test) to assess stent permeability and Cox regression for associated factors were performed.

Results: Fifty-eight patients were included. Median follow-up was 36 months (11-82). Median age was 61 years (48-68). Most frequent aetiology of ureteral stenosis was malignancy in 30 cases (53.6%). The most common location of stricture was distal ureter in 44 (63.8%) ureteral strictures. Creatinine levels improved in 28 (48.3%) cases. Most common acute complication was urinary tract infection in 6 (3.4%) patients (Clavien-Dindo II). Twenty patients presented with stent obstruction. Fourteen (24.1%) were solved with double J stenting and 6 (10.3%) cases with PCN. Mean stent survival time was 50 months (34.3-65.8). By the end of follow-up, 23 (39.6%) patients were alive. Of those, 9 (39.1%) had a functioning stent. No association of any factor with patency of stent was found.

Conclusions: Expandable ureteral stents are an alternative to PCN in fragile patients with refractory stenosis, which offers a better quality of life.

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自体可扩张金属输尿管支架治疗复杂输尿管狭窄：一所高等教育机构的长期疗效。

导读：对于难治性输尿管狭窄，自动可扩张输尿管支架可以作为经皮肾造口术（PCN）的替代方法。我们的目的是分析输尿管支架手术的结果和并发症。方法：回顾性分析1996-2022年在本中心放置的OptiMed®可扩张输尿管支架。并发症分析（Clavien-Dindo分型）。Kaplan-Meier曲线（长秩检验）评估支架通透性，Cox回归分析相关因素。结果：纳入58例患者。中位随访：36个月（11-82）。中位年龄：61岁（48-68岁）。输尿管狭窄最常见的病因为恶性肿瘤30例（53.6%）。输尿管狭窄44例（63.8%）中以输尿管远端狭窄最为常见。肌酐水平改善28例（48.3%）。最常见的急性并发症是尿路感染，6例（3.4%）患者（Clavien-Dindo II）， 20例患者出现支架阻塞。双J型支架置入14例（24.1%），PCN置入6例（10.3%）。平均支架生存时间为50个月（34.3-65.8）。随访结束时，23例（39.6%）患者存活。其中9例（39.1%）支架功能正常。没有发现任何因素与支架通畅相关。结论：可扩张输尿管支架是治疗难治性狭窄的虚弱患者的一种可替代PCN的方法，可提供更好的生活质量。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Urologia Internationalis 医学-泌尿学与肾脏学

CiteScore

3.30

自引率

6.20%

发文量

审稿时长

3-8 weeks

期刊介绍： Concise but fully substantiated international reports of clinically oriented research into science and current management of urogenital disorders form the nucleus of original as well as basic research papers. These are supplemented by up-to-date reviews by international experts on the state-of-the-art of key topics of clinical urological practice. Essential topics receiving regular coverage include the introduction of new techniques and instrumentation as well as the evaluation of new functional tests and diagnostic methods. Special attention is given to advances in surgical techniques and clinical oncology. The regular publication of selected case reports represents the great variation in urological disease and illustrates treatment solutions in singular cases.