Clinical Evaluation of Ureteral Stenting for Managing Extrinsic Ureteral Obstruction Due to Gynecological and Gastrointestinal Cancer

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  • Takehara, Kosuke
    The Department of Nephro-Urology, Nagasaki University Graduate School of Biomedical Sciences
  • Onita, Toru
    The Department of Nephro-Urology, Nagasaki University Graduate School of Biomedical Sciences
  • Mochizuki, Yasushi
    The Department of Nephro-Urology, Nagasaki University Graduate School of Biomedical Sciences
  • Miyata, Yasuyoshi
    The Department of Nephro-Urology, Nagasaki University Graduate School of Biomedical Sciences
  • Igawa, Tsukasa
    The Department of Nephro-Urology, Nagasaki University Graduate School of Biomedical Sciences
  • Sakai, Hideki
    The Department of Nephro-Urology, Nagasaki University Graduate School of Biomedical Sciences

Bibliographic Information

Other Title
  • 婦人科癌および消化器癌による尿管閉塞に対する尿管ステント留置術の検討
  • フジンカガン オヨビ ショウカキガン ニ ヨル ニョウカン ヘイソク ニ タイスル ニョウカン ステント リュウチジュツ ノ ケントウ

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Description

We retrospectively reviewed patients who were treated with an indwelling ureteral stent to manage extrinsic ureteral obstruction due to advanced gynecological and gastrointestinal cancers. A total of 34 patients, including 17 with gynecological cancer and 17 with gastrointestinal cancer, underwent a successful initial ureteral stent placement from January2007 to December 2011. Functional ureteral stent failures, which required percutaneous nephrostomy within 3 months after initial ureteral stenting, occurred in 14 of the 34 patients (41%) during follow-up. The risk factors of functional ureteral stent failure were bilateral ureteral obstruction, elevated serum creatinine level, poor performance status, subsequent therapy for primary cancer after ureteral stent placement, presence of peritonitis carcinomatosa, and gastrointestinal cancer. Patients with gastrointestinal cancer had a higher rate of stent failure than did those with gynecological cancer (p＝0.01). Median survival from the diagnosis of hydronephrosis for patients with gastrointestinal and gynecological cancers was 9 and 23 months, respectively (p＝0. 02). Retrograde ureteral stenting is a useful treatment for malignant ureteral obstruction. However, patients with gastrointestinal cancer had a high stent failure rate and a short survival time from the diagnosis of hydronephrosis. Indications for retrograde ureteral stenting for malignant ureteral obstruction should be carefully considered while taking into account stent failure risk, patient prognosis and quality of life.

Journal

  • Hinyokika Kiyo

    Hinyokika Kiyo 60 (1), 13-16, 2014-01

    泌尿器科紀要刊行会

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