Endourologic Treatments of Distal Ureteral Obstruction in Patients with History of Pelvic Malignancies:Efficacy and Safety Evaluation
10.3321/j.issn:1000-467x.2007.11.014
- VernacularTitle:盆腔恶性肿瘤术后输尿管下段梗阻的腔镜手术治疗
- Author:
Xing-Qiao WEN
1
;
Xin GAO
;
Yong ZHANG
;
Yu-Bin CAI
;
Jian-Guang QIU
;
Jie SITU
;
Hai-Lun ZHAN
;
De-Juan WANG
Author Information
1. 中山大学附属第三医院
- Keywords:
Laparoscopy;
Ureteroscopy;
Ureteral obstruction/ complication;
Surgical operation;
Pelvic neoplasm
- From:Chinese Journal of Cancer
2007;26(11):1227-1230
- CountryChina
- Language:Chinese
-
Abstract:
BACKGROUND & OBJECTIVE: Postoperative tissue adherence, scarring and radiotherapy often lead to extrinsic compression and stricture in the distal ureter of the patients who had history of pelvic malignancies. Our aim was to evaluate the efficacy and safety of endourologic techniques in treating this kind of ureteral obstruction. METHODS: From Jan. 1998 to Mar. 2007, 46 patients with obstruction in the distal ureter and had history of pelvic malignancies underwent endoscopic treatments at the Third Affiliated Hospital of Sun Yat-sen University for relief of the obstruction. Perioperative and follow-up data were analyzed. RESULTS: Of the 46 patients, 25 underwent laparoscopic ureterolysis and ureteroneocystostomy, 18 underwent placement of ureter stent under ureteroscope, 3 underwent percutaneous nephrostomy. No severe complication was recorded. The mean operating time was 82.5 min (range, 30-140 min). The mean blood loss was 45.5 ml (range, 5-180 ml). No blood transfusion was needed. The median follow-up time was 18.2 months (range, 3 months to 6.5 years). Three months after operation, B-ultrasonography and intravenous urography (IVU) showed that 39 (84.8%) patients had recovered normal renal function, the other 7 (15.2%) had hydronephrosis relief and renal function improvement. Nuclear renal scanning showed that the mean postoperative glomerular filtration rate (GFR) in the obstructive kidney was higher than the preoperative level (37.6 ml/min vs. 21.3 ml/min, P＜0.05). No stricture in the uretero-bladder anastomotic stoma was recorded. CONCLUSION: Endoscopic operation is an effective and feasible option for managing some selected kinds of distal ureteral obstruction caused by postoperative tissue adherence and radiotherapy in the patients with history of pelvic malignancies.
