Comparison of Two Types of Double-J Ureteral Stents that Differ in Diameter and the Existence of Multiple Side Holes along the Straight Portion in Malignant Ureteral Strictures
Tóm tắt
This study was decided to evaluate the impact of diameter and the existences of multiple side holes along the straight portion of double-J ureteral stents (DJUS) on early dysfunction of stents placed for malignant ureteral strictures.
Between April 2007 and December 2011, 141 DJUSs were placed via a percutaneous nephrostomy (PCN) tract in 110 consecutive patients with malignant ureteral strictures. 7F DJUSs with multiple side holes in the straight portion were placed in 58 ureters of 43 patients (Group 1). 8F DJUSs with three side holes in the proximal 2-cm of the straight portion were placed in 83 ureters of 67 patients (Group 2). The incidence of early DJUS dysfunction was compared between the two groups, and nephrostographic findings were evaluated in the cases of early dysfunction. Early dysfunction of the DJUS was noted in 14 of 58 patients (24.1 %) in Group 1, which was significantly higher (p = 0.001) than in Group 2 in which only 1 of 83 patients (1.2 %) had early dysfunction of the DJUS. Nephrostographic findings of early dysfunction included dilatation of the pelvicalyceal system, filling defects in the ureteral stent, and no passage of contrast media into the urinary bladder. In malignant ureteral strictures, multiple side holes in the straight portion of the 7-F DJUS seem to cause early dysfunction. The 8F DJUSs with three side holes in the proximal 2-cm of the straight portion may be superior at preventing early dysfunction.
Tài liệu tham khảo
Zimskind PD, Fetter TR, Wilkerson JL (1967) Clinical use of long-term indwelling silicone rubber ureteral splints inserted cystoscopically. J Urol 97(5):840–844
McCullough DL (1974) ‘Shepherds crook’ self-retaining ureteral catheter. Urol Lett Club 32:54–55
Druy EM (1985) A dilating introducer-sheath for the antegrade insertion of ureteral stents. AJR Am J Roentgenol 145(6):1274–1276
Finney RP (1978) Experience with new double J ureteral catheter stent. J Urol 120(6):678–681
Hepperlen TW, Mardis HK, Kammandel H (1978) Self-retained internal ureteral stents: a new approach. J Urol 119(6):731–734
Mitty HA et al (1988) Experience with a new ureteral stent made of a biocompatible copolymer. Radiology 168(2):557–559
Tschada RK et al (1994) Spiral-reinforced ureteral stent: an alternative for internal urinary diversion. J Endourol 8(2):119–123
Soh KC et al (2008) Is the routine check nephrostogram following percutaneous antegrade ureteric stent placement necessary? Cardiovasc Interv Radiol 31(3):604–609
Seymour H, Patel U (2000) Ureteric stenting: current status. Semin Interv Radiol 17:351–366
Smedley FH et al (1988) 168 double J (pigtail) ureteric catheter insertions: a retrospective review. Ann R Coll Surg Engl 70(6):377–379
Tong JC, Sparrow EM, Abraham JP (2007) Numerical simulation of the urine flow in a stented ureter. J Biomech Eng 129(2):187–192
Christman MS et al (2009) Analysis of ureteral stent compression force and its role in malignant obstruction. J Urol 181(1):392–396
Kunamneni A et al (2008) Urokinase-a very popular cardiovascular agent. Recent Pat Cardiovasc Drug Discov 3(1):45–58
Docimo SG, Dewolf WC (1989) High failure rate of indwelling ureteral stents in patients with extrinsic obstruction: experience at 2 institutions. J Urol 142(2 Pt 1):277–279
Dyer RB et al (2002) Complications of ureteral stent placement. Radiographics 22(5):1005–1022