Ureteral decompression in advanced nonurologic malignancies
Ureteral decompression in advanced nonurologic malignancies
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DOI：
10.1007/bf02305670
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发表时间：
1996-07-01
影响因子：
3.7
通讯作者：
Russo, P
中科院分区：
文献类型：
--
作者：
Donat, SM;Russo, P
背景资料：本研究的目的是评估的发病率，并确定生存后，输尿管减压的患者与先进的nonurologic malignances.Methods：在1988年6月至1993年6月78例患者被称为一个单一的外科医生输尿管减压。记录进行了分析，初步诊断，早期和晚期并发症，住院人数，和生存后decompensation.Results：72%的患者最初进行减压内镜，28%的患者需要经皮肾造口术放置在初始减压。50%的患者发生并发症，最常见的包括感染（29%）、支架阻塞和结壳（28%）以及肉眼血尿（9%）。所有患者在首次减压手术后的中位生存期为6.8个月（范围0.5-46.1），1年的精算生存率为55%，3年为30%。8名胃癌/胰腺癌患者在减压后的平均生存时间仅为1.4个月（范围0.77-11.8），1年精算生存率为12.5%，3年精算生存率为0%，与所有其他组一起或单独相比，明显更差结论：晚期癌症患者的输尿管减压术是姑息治疗的一个重要组成部分，但在中位生存期<10年的患者中，
Background: The purpose of this study was to assess the morbidity and determine survival after ureteral decompression in patients with advanced nonurologic malignancies.Methods: Between June 1988 and June 1993 78 patients were referred to a single surgeon for ureteral decompression. Records were analyzed in relation to primary diagnosis, early and late complications, number of hospitalizations, and survival after decompression.Results: Seventy-two percent of patients initially underwent decompression endoscopically, and 28% required percutaneous nephrostomy placement at initial decompression. Complications occurred in 50% of patients and most commonly included infection (29%), stent obstruction and encrustation (28%), and gross hematuria (9%). The median survival for all patients after the first decompression procedure was 6.8 months (range 0.5-46.1), with an actuarial survival rate at 1 year of 55% and at 3 years of 30%. The eight patients with gastric/pancreatic cancer survived a median of just 1.4 months after decompression (range 0.77-11.8), with a 1-year actuarial survival rate of 12.5% and 3-year actuarial survival of 0%, which was significantly worse when compared with all other groups taken together or individually (p < 0.03).Conclusions: Ureteral decompression procedures in patients with advanced cancer can be an important component of palliative care but are associated with significant morbidity (50%) in patients whose median survival is