Stenting Using the Rendezvous Technique for Postoperative Ureteral Complications in Cancer Patients
Stenting Using the Rendezvous Technique for Postoperative Ureteral Complications in Cancer Patients
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DOI：
10.1007/s00270-020-02546-x
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发表时间：
2020-06-12
影响因子：
2.9
通讯作者：
Arai, Yasuaki
中科院分区：
文献类型：
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作者：
Kawada, Hiroshi;Sato, Yozo;Arai, Yasuaki
目的探讨应用交会技术放置输尿管支架治疗癌症患者术后输尿管并发症的安全性和有效性。材料与方法2005年1月至2015年4月，19例单侧输尿管病变患者(男2例，女17例；中位年龄59岁；年龄42~79岁)，其中输尿管漏6例，狭窄4例，同时狭窄9例。行经皮肾造口术，并尝试通过顺行和逆行途径放置支架。对技术成功、手术相关并发症和临床成功进行回顾性分析。结果中位随访期为29.8个月(0.3~116.5个月)。输尿管支架置入成功率89.5%(17/19)。6例采用双J管，11例采用直管作为内-外肾输尿管支架。腹膜后间隙会合术6例，尿路会合术11例。没有发生与会合技术有关的重大并发症。无支架4例(21.1%)，定期更换支架9例(47.4%)。永久性外引流4例(21.1%)，手术重建2例(10.5%)。最终临床成功率为68.4%(13/19例)。结论采用交会技术放置输尿管支架治疗癌症患者术后输尿管并发症是安全的，可替代永久性外引流和有创手术重建。
Purpose This study aimed to retrospectively evaluate the safety and efficacy of ureteral stent placement using the rendezvous technique for the treatment of postoperative ureteral complications in cancer patients. Materials and Methods From January 2005 to April 2015, 19 patients (2 men and 17 women; median age, 59; range, 42-79 years old) with unilateral ureteral lesions (ureteral leakages in 6, strictures in 4, and both in 9) underwent ureteral stent placement using the rendezvous technique. Percutaneous nephrostomy was performed, and stent placement was attempted via antegrade and retrograde approaches. The technical success, procedure-related complications, and clinical success were retrospectively analyzed. Results The median follow-up period was 29.8 months (range, 0.3-116.5 months). The ureteral stent placement was successful in 17 out of 19 patients (89.5%). Double J ureteral stent was used in 6 patients, and straight catheter as an internal-external nephro-ureteral stent was used in 11 patients. The rendezvous technique was used in the retroperitoneal space and urinary tract in 6 and 11 patients, respectively. No major complications related to the rendezvous technique occurred. Finally, 4 patients achieved stent-free condition (21.1%), and periodic stent exchange was continued in 9 (47.4%). However, permanent external drainage and surgical reconstruction were needed in 4 (21.1%) and 2 (10.5%) patients, respectively. The final clinical success rate was 68.4% (13 out of 19 patients). Conclusion Ureteral stent placement using the rendezvous technique for the treatment of postoperative ureteral complications in cancer patients is safe and may be alternative to permanent external drainage and invasive surgical reconstruction.