Endourological treatment of ureteral strictures with the use of self-expanding stents: is it possible to completely cure the stricture endoscopically? A report on the experience with implantation of 35 stents with a two-year follow-up period; a retrospective study.

IF 2.8 2区 医学 Q2 UROLOGY & NEPHROLOGY
Filip Kowalski, Błażej Kuffel, Michał Późniak, Pavel Lipowski, Michal Czarnogorski, Jacek Wilamowski, Adam Ostrowski, Jan Adamowicz, Tomasz Drewa
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引用次数: 0

Abstract

Background: The current results of endoscopic treatment of ureteral strictures are characterized by very divergent treatment results, which is due to a wide range of criteria for including patients in the analyses and different definitions of effective treatment. In this retrospect study we wanted to introduce a possibility of curing ureteral strictures depending on their type and degree with the use of self-expanding ureteral stents (SUS).

Methods: 33 patients with ureteral strictures received endourological treatment with the use of Allium® SUS (2 patients with SUS placed on both sides). Patients were divided into 2 groups: patients with uncomplicated strictures (Grp 1) and patients with complicated strictures (Grp 2). Uncomplicated stricture was defined as a single stricture below 2 cm. A complicated stricture was defined as a stricture over 2 cm and/or multiple strictures. The follow-up time was 24 months. All patients were scheduled for renoscintigraphy during the treatment. A full therapeutic success was defined as no tight stenosis in renoscintigraphic furosemide test after SUS explantation.

Results: In Grp 1, full therapeutic success was achieved in 80% of patients, which was statistically significant (p < 0.001). Serious complications (Clavien-Dindo > 3a) occurred significantly more often in Grp 2 (p = 0.046). Renal outflow during stenting was present in 70% of the patients in Grp 2.

Conclusions: A full therapeutic success of endoscopic, SUS-assisted treatment can be considered among patients with short, single ureteral stricture. In long and/or multiple strictures, SUS can be used as drainage element, but full recovery of the stricture is unlikely.

输尿管狭窄的腔内治疗与自扩支架的应用:是否有可能在内镜下完全治愈狭窄?35例支架植入术,随访2年。回顾性研究。
背景:目前输尿管狭窄的内镜治疗结果差异很大,这是由于纳入分析的患者标准不同,有效治疗的定义不同。在这项回顾性研究中,我们想介绍一种治疗输尿管狭窄的可能性,这取决于输尿管狭窄的类型和程度,使用自扩张输尿管支架(SUS)。方法:33例输尿管狭窄患者采用Allium®SUS进行输尿管内腔治疗(2例两侧放置SUS)。将患者分为2组:无复杂性狭窄(Grp 1)和复杂狭窄(Grp 2)。无复杂性狭窄定义为单个狭窄小于2 cm。复杂狭窄定义为超过2厘米的狭窄和/或多个狭窄。随访24个月。所有患者在治疗期间均安排进行肾造影检查。完全治疗成功的定义是在SUS外植后的肾造影速尿试验中没有狭窄。结果:在第1组中,80%的患者获得完全治疗成功,有统计学意义(p 3a),在第2组中出现的频率明显高于第2组(p = 0.046)。在第2组中,70%的患者在支架植入期间出现肾流出。结论:对于短单输尿管狭窄的患者,内镜下、超声辅助下的治疗是完全成功的。在长和/或多个狭窄中,SUS可以用作引流元件,但不太可能完全恢复狭窄。
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
World Journal of Urology
World Journal of Urology 医学-泌尿学与肾脏学
CiteScore
6.80
自引率
8.80%
发文量
317
审稿时长
4-8 weeks
期刊介绍: The WORLD JOURNAL OF UROLOGY conveys regularly the essential results of urological research and their practical and clinical relevance to a broad audience of urologists in research and clinical practice. In order to guarantee a balanced program, articles are published to reflect the developments in all fields of urology on an internationally advanced level. Each issue treats a main topic in review articles of invited international experts. Free papers are unrelated articles to the main topic.
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