Oblique supine lithotomy position percutaneous antegrade ureteral endoscopy combined with retrograde ureteroscopy for complex malignant ureteral obstruction

doi:10.3877/cma.j.issn.1674-3253.2022.01.014

Abstract

Abstract:

Objective

To investigate the clinical safety and effects of oblique supine lithotomy position percutaneous antegrade ureteral flexible/ rigid endoscopy combined with retrograde ureteroscopy in the treatment of ureteral stent implantation failure ureteral obstruction caused by malignant tumors.

Methods

A retrospective study was conducted to collect and analyze the data of 25 patients with ureteral obstruction caused by malignant tumors treated in our hospital from October 2016 to January 2019. All these patients failed of double J stent placement under conventional retrograde cystoscopy or ureteroscopy. Under the oblique supine lithotomy position, a double J tube was placed by percutaneous renal channel antegrade ureteral flexible/ rigid endoscopy combined with ureteroscopy.

Results

Double J tubes were successfully placed in 24 cases (30 sides of ureter, 93.7% success rate), except for 1 case failed due to complete occlusions of the bilateral ureteral lumen by tumor invasion. The average operation time was (57.4 ±22.4) minutes and the average hospital stay was (5.5±1.9) days. There was no severe renal hemorrhage and no ureteral perforation and avulsion during the operation. The nephrostomy tube was removed 6- 14 days after the operation. Hydronephrosis was significantly relieved during the 12 months follow-up.

Conclusions

Oblique supine lithotomy position percutaneous antegrade ureteral flexible / rigid endoscopy combined with retrograde ureteroscopy for the treatment of ureteral stent implantation failure ureteral obstruction caused by malignant tumors is safe and effective, and worthy of clinical promotion.

Key words: Oblique supine lithotomy position, Ureteral obstruction, Percutaneous nephroscope, Flexible ureteroscopy

Bo Li, Guojun Wu, Zhenyu Li, Jianlin Yuan, Wanxiang Zheng, Lijun Yang, Fuli Wang, Fei Liu. Oblique supine lithotomy position percutaneous antegrade ureteral endoscopy combined with retrograde ureteroscopy for complex malignant ureteral obstruction[J]. Chinese Journal of Endourology(Electronic Edition), 2022, 16(01): 64-68,80.

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References 17

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项目		数值
年龄[岁，(±s)]		55±9
性别
	男	9
	女	16
狭窄段长度[cm，(±s)]		2.4±0.7
狭窄位置分布（侧）
	输尿管上段	14
	输尿管中端	8
	输尿管下段	10
	单侧	18
	双侧	7
置管失败原因（例）
	未找到输尿管口	9
	导丝不能通过狭窄段	16
手术时间[min，(±s)]		57±22
住院日[d，(±s)]		5.5±1.9
术后并发症（例）
	血尿	18
	感染	3
	支架移位	2

项目		数值
年龄[岁，(±s)]		55±9
性别
	男	9
	女	16
狭窄段长度[cm，(±s)]		2.4±0.7
狭窄位置分布（侧）
	输尿管上段	14
	输尿管中端	8
	输尿管下段	10
	单侧	18
	双侧	7
置管失败原因（例）
	未找到输尿管口	9
	导丝不能通过狭窄段	16
手术时间[min，(±s)]		57±22
住院日[d，(±s)]		5.5±1.9
术后并发症（例）
	血尿	18
	感染	3
	支架移位	2

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