Application of Resonance metallic ureteral double J tube in ureteral obstruction associated with malignant diseases

doi:10.3877/cma.j.issn.1674-3253.2018.04.009

Abstract

Abstract:

Objective

To compare the effecacy of Resonance metallic ureteral double J tube and traditional polymer double J tube in the removal of ureteral obstruction associated with malignant diseases.

Methods

The medical records of 69 patients with upper urinary tract hydrops caused by invasion of advanced malignant tumors or compression of ureter treated in the Sixth Affiliated Hospital of Sun Yat-sen University from January 2013 to January 2016 were analyzed retrospectively. All patients treated with retrograde placement of Resonance ureteral metallic double J tube (RMU group) or traditional polymer double J tube (T group) to remove the obstruction which was carried out by the same physicians in the department. In RMU group, the renal pelvis separation, number of upper ureteral obstruction, number of distal obstruction and the level of preoperative creatinine were (31±10) mm, 15, 53 and 115.5(85.7) μmol/L, respectively, while those in T group were (29±7) mm, 7, 16 and 104(101) μmol/L, respectively (P>0.05). The success rate of intubation, patency rate of stent drainage, duration of stent drainage and the incidence of complications in the two groups were evaluated.

Results

The clinical data of 69 patients (91 ureteral units) were collected and 50 patients (68 ureteral units) were included in the RMU group and were followed up for an average of 250 days. Nighteen patients (23 ureteral units) were included in T group and were followed up for an average of 203 days. There was no statistically significant difference between the two groups in the success rate of intubation (89.7% vs 87.0%, P>0.05). The patency rates of drainage in RMU group were significantly higher than those in T group, and the average duration of drainage was significantly longer than that of T group (P<0.05). The total incidence of complications in RMU group was lower than that in T group (46.0% vs 73.7%) (P<0.05).

Conclusion

The success rate of inserting Resonance metallic double J tube is similar to that of traditional polymer double J tube in relieving ureteral obstruction associated with malignant diseases. However, the drainage effect of the former is better than the latter, and the complications are fewer.

Key words: Malignant diseases, Ureteral obstruction, Ureteral stent, Curative effect, Complication

Bo Ma, Chunqiang Jiang, Wenwen Zhong, Xutao Lin, Zhongyang Wang. Application of Resonance metallic ureteral double J tube in ureteral obstruction associated with malignant diseases[J]. Chinese Journal of Endourology(Electronic Edition), 2018, 12(04): 248-253.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhqjmnmwkzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-3253.2018.04.009

https://zhqjmnmwkzz.cma-cmc.com.cn/EN/Y2018/V12/I04/248

Figures/Tables 6

References 17

[1]	Liberman D,McCormack M. Renal and urologic problems: management of ureteric obstruction[J]. Curr Opin Support Palliat Care, 2012, 6(3): 316-321.
[2]	Wang JY,Zhang HL,Zhu Y, et al. Predicting the failure of retrograde ureteral stent insertion for managing malignant ureteral obstruction in outpatients[J]. Oncol Lett, 2016, 11(1): 879-883.
[3]	赵勇,李涛. 恶性肿瘤引起输尿管梗阻的外科治疗进展[J/CD]. 中华腔镜泌尿外科杂志(电子版), 2015, 9(2): 146-150.
[4]	Izumi K,Mizokami A,Maeda Y, et al. Current outcome of patients with ureteral stents for the management of malignant ureteral obstruction[J]. J Urol, 2011, 185(2): 556-561.
[5]	Baumgarten AS,Hakky TS,Carrion RE, et al. A single-institution experience with metallic ureteral stents: a cost-effective method of managing deficiencies in ureteral drainage[J]. Int Braz J Urol, 2014, 40(2): 225-231.
[6]	Borin JF,Melamud O,Clayman RV. Initial experience with full-length metal stent to relieve malignant ureteral obstruction[J]. J Endourol, 2006, 20(5): 300-304.
[7]	Ganatra AM,Loughlin KR. The management of malignant ureteral obstruction treated with ureteral stents[J]. J Urol, 2005, 174(6): 2125-2128.
[8]	Li CC,Li JR,Huang LH, et al. Metallic stent in the treatment of ureteral obstruction: experience of single institute[J]. J Chin Med Assoc, 2011, 74(10): 460-463.
[9]	Wang HJ,Lee TY,Luo HL, et al. Application of resonance metallic stents for ureteral obstruction[J]. BJU Int, 2011, 108(3): 428-432.
[10]	Blaschko SD,Deane LA,Krebs A, et al. In-vivo evaluation of flow characteristics of novel metal ureteral stent[J]. J Endourol, 2007, 21(7): 780-783.
[11]	Benson AD,Taylor ER,Schwartz BF. Metal ureteral stent for benign and malignant ureteral obstruction[J]. J Urol, 2011, 185(6): 2217-2222.
[12]	Nagele U,Kuczyk MA,Horstmann M, et al. Initial clinical experience with full-length metal ureteral stents for obstructive ureteral stenosis[J]. World J Urol, 2008, 26(3): 257-262.
[13]	Christman MS,L'esperance JO,Choe CH, et al. Analysis of ureteral stent compression force and its role in malignant obstruction[J]. J Urol, 2009, 181(1): 392-396.
[14]	Liatsikos E,Kallidonis P,Kyriazis I, et al. Ureteral obstruction: is the full metallic double-pigtail stent the way to go?[J]. Eur Urol, 2010, 57(3): 480-486.
[15]	Chow PM,Chiang IN,Chen CY, et al. Malignant Ureteral Obstruction: Functional Duration of Metallic versus Polymeric Ureteral Stents[J]. PLoS One, 2015, 10(8): e0135566.
[16]	Cauda V,Fiori C,Cauda F. Ni-Cr-Co alloy ureteral stent: scanning electron microscopy and elemental analysis characterization after long-term indwelling[J]. J Biomed Mater Res B Appl Biomater, 2010, 94(2): 501-507.
[17]	Rao MV,Polcari AJ,Turk TM. Updates on the use of ureteral stents: focus on the Resonance(^®)stent[J]. Med Devices (Auckl), 2011, 4: 11-15.

组别	例数	性别（例）		年龄（岁，±s）	肾盂分离（mm，±s）	输尿管梗阻部位（例）		术前肌酐[μmol/L，M(Q)]
组别	例数	男	女	年龄（岁，±s）	肾盂分离（mm，±s）	上段	中下段	术前肌酐[μmol/L，M(Q)]
RMU组	50例(68条)	27	23	59±14	31±10	15	53	115.5(85.7)
T组	19例(23条)	10	09	56±16	29±70	07	16	0.104(101)
统计值		χ²=0.010		t=0.667	t=1.147	χ²=0.658		Z=-0.235
P值		0.919		0.507	0.254	0.417		0.814

组别	例数	性别（例）		年龄（岁，±s）	肾盂分离（mm，±s）	输尿管梗阻部位（例）		术前肌酐[μmol/L，M(Q)]
组别	例数	男	女	年龄（岁，±s）	肾盂分离（mm，±s）	上段	中下段	术前肌酐[μmol/L，M(Q)]
RMU组	50例(68条)	27	23	59±14	31±10	15	53	115.5(85.7)
T组	19例(23条)	10	09	56±16	29±70	07	16	0.104(101)
统计值		χ²=0.010		t=0.667	t=1.147	χ²=0.658		Z=-0.235
P值		0.919		0.507	0.254	0.417		0.814

组别	数量（条）	位置异常数	置管成功数	置管成功率
RMU组	68	7	61	89.7%
T组	23	3	20	87.0%

组别	数量（条）	位置异常数	置管成功数	置管成功率
RMU组	68	7	61	89.7%
T组	23	3	20	87.0%

组别	例数	引流通畅率[例（%）]			平均引流持续时间[d，M(Q)]
组别	例数	30 d	60 d	90 d	平均引流持续时间[d，M(Q)]
RMU组	50例(68条)	65(95.6)	62(91.2)	60(88.2)	136.5(119.2)
T组	19例(23条)	19(82.6)	16(69.6)	7(30.4)	70.0(75.0)
统计值		χ²=2.455	χ²=4.909	χ²=29.570	Z=-3.325
P值		0.117	0.027	<0.001	0.001

Please choose a citation manager

Content to export