Document Detail


Long-term results of metallic stents for malignant ureteral obstruction in advanced cervical carcinoma.
MedLine Citation:
PMID:  23199302     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Purpose- We present our experience with the use of metallic stents (wallstents) in the management of malignant ureteral obstruction in order to maintain renal function thereby permitting the use of chemotherapeutic agents treating the underlying malignancy. Materials and Methods- We retrospectively reviewed the records of 24 patients with ureteral obstruction secondary to advanced cervical carcinoma, stage T3b (n=10) and T4 (n=14), that was relieved by wallstents. Nineteen patients required bilateral and 5 required unilateral wallstents to relieve the obstruction. Fifty-six additional endourologic interventions were necessary to assure continued patency. Holmium laser ablation was utilized 14 times to manage tumor proliferation and ingrowth at the distal end of the stent. Thirty-two endostents, 4 extension and 6 replacement stents were used to maintain patency of the ureter. Results- Nineteen of our 24 patients received between 1-5 chemotherapeutic cycles over 18-140 months. In 5 patients, placement of wallstents did not achieve adequate decrease of the creatinine levels to allow treatment with chemotherapy. Thirteen of 24 wallstents remained patent over 18 months, yielding a primary patency rate of 54%. Technical success rate of wallstent placement was 100%. The overall mean primary and secondary patency rates of the stent was 16.5 and 52 months respectively. For T3b and T4 patients, the mean primary patency rate was 20.6 and 13.6 months respectively. Secondary patency for T3b patients was 73.9 months versus 36.4 months for T4 patients. There were no serious complications associated with wallstent placement. Conclusion. Wallstents offer a salutary solution to the problem of maintaining prolonged patency of ureters compromised by encasing neoplasms.
Authors:
Erich Lang; Andrew Gordon Winer; Geraldine Abbey-Mensah; Raja Anne; Atabak Allaei; Fara Friedman; Raju Thomas; Joseph La Nasa; Rodney Davis
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-30
Journal Detail:
Title:  Journal of endourology / Endourological Society     Volume:  -     ISSN:  1557-900X     ISO Abbreviation:  J. Endourol.     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-12-3     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8807503     Medline TA:  J Endourol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
SUNY Downstate, radiology, Brooklyn, New York, United States; erich.lang@downstate.edu.
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