Selection for percutaneous nephrostomy in gynecologic cancer patients.
Selection for percutaneous nephrostomy in gynecologic cancer patients.
复制标题
妇科癌症患者经皮肾造口术的选择。
DOI：
10.1016/0090-8258(91)90231-s
复制
发表时间：
1991
影响因子：
4.7
通讯作者：
J. Boyce
中科院分区：
文献类型：
--
作者：
G. Feuer;R. Fruchter;Eli Seruri;M. Maiman;J. Remy;J. Boyce
对于存在输尿管梗阻的妇科癌症患者，通常很难确定是否适合使用肾造瘘管进行干预。本研究旨在确定经皮肾造口术前的评估是否可以准确预测哪些患者将从干预中获益。22例妇科癌症患者双侧输尿管梗阻进行了评估。禁忌干预的标准包括治疗期间疾病进展、潜在危及生命的医学问题、Zubrod体力状态大于2、无有效治疗、不依从和疼痛控制不良。一个单一的标准是足够的矛盾经皮肾造口术放置。包括置换肾造瘘术在内，19例患者共放置46个经皮肾造瘘术和4个支架。3例患者未进行干预。根据预测标准，只有9例患者对经皮肾造瘘术的放置没有任何矛盾。无经皮肾造口术禁忌症的患者生存时间更长（中位天数，242 vs 37;P< 0.05），生活质量改善（中位居家天数，164 vs 2;P< 0.05），经皮肾造口术后接受治疗的机会更大（9 vs 2例患者;P< 0.05）。经皮肾造口术前的评估可能有助于指导医生推荐干预措施。
For patients with gynecologic cancers who present with ureteral obstruction, it is often difficult to determine whether intervention with nephrostomy tube is appropriate. This study was designed to determine if evaluation prior to percutaneous nephrostomy could accurately predict patients who would benefit from intervention. Twenty-two gynecologic cancer patients with bilateral ureteral obstruction were evaluated. Criteria contraindicating intervention included disease progression while on therapy, potentially life-threatening medical problems, Zubrod performance status greater than 2, no available efficacious therapy, noncompliance, and poor pain control. A single criterion was sufficient to contradindicate percutaneous nephrostomy placement. Including replacement nephrostomies, a total of 46 percutaneous nephrostomies and four stents were placed in 19 patients. Three patients had no intervention. Only 9 patients did not have any contradictions to placement of percutaneous nephrostomy, based on predictive criteria. Patients without contraindications to percutaneous nephrostomy survived longer (median days, 242 versus 37;P< 0.05), had improved quality of life (median days at home, 164 versus 2;P< 0.05), and had a better chance of receiving therapy after percutaneous nephrostomy (9 versus 2 patients;P< 0.05). Assessment prior to percutaneous nephrostomy maybe helpful in guiding the physician in recommending intervention.