Self-expanding metal ureteral stent for ureteral stricture: Experience of a large-scale prospective study from a high-volume center - Cross-sectional study

Gao, Xiaoshuai; Song, Ting; Liao, Peng; Yuan, Cheng; Wang, Wei; Chen, Jixiang; Xiao, Kan; Wei, Xin

doi:10.1016/j.ijsu.2021.106161

Cited by 15 publications

(12 citation statements)

References 23 publications

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“…A large-scale prospective study with 147 patients receiving 157 Allium stents, reported effective urinary drainage in nearly all patients. The most common complications were hematuria (13 cases, 8.8%), followed by urinary tract infection (11 cases, 7.5%) and pain (8 cases, 5.4%), and distal ureteral stenosis was found to be an independent predictor of stent failure [29].…”

Section: Discussionmentioning

confidence: 97%

Allium covered metal stent for treatment of malignant ureteral obstruction

Zhang

et al. 2023

Preprint

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Objective. To evaluate the safety and efficacy of the Allium covered metallic stent for the treatment of malignant ureteral obstruction. Patients and Methods. Clinical data of 29 patients who underwent endoscopic insertion of an Allium ureteral stent between October 2019 and August 2021 at Yongchuan Hospital, affiliated with Chongqing Medical University, were analyzed retrospectively. At 1, 3, 6 and 12 months after insertion, serum creatinine was measured, the width of the renal pelvis was rechecked under ultrasound guidance, and the position and shape of the stent were checked by abdominal X-ray. Data on long-term stent patency, incidence of complications, changes in renal function and hydronephrosis grade were collected and analyzed. Ureteral stent symptom questionnaire (USSQ) was administered preoperatively and after 6 months in 22 patients with previous stent history. Results. Allium covered metal stents (n=33) were implanted successfully in 29 patients who were followed for 3 to 22 months, with 32/33 stents remaining patent. Serum creatinine levels decreased in 17 patients and hydronephrosis in 24 patients. Clavien-Dindo grade I complications were observed in 6 patients, Clavien-Dindo II in 1 patient, whereas stent displacement and stent encrustation occurred in one patient each (Clavien-Dindo III-IV). USSQ scores had significantly improved 6 months after stent insertion (p<0.001). Conclusion Allium ureteral stents are a safe and effective treatment option for malignant ureteral obstruction, with good long-term patency, helping to preserve renal function and improve quality of life.

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Section: Discussionmentioning

confidence: 97%

Allium covered metal stent for treatment of malignant ureteral obstruction

Zhang

et al. 2023

Preprint

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“…In our study, the stent migration rate was 11.1% (3/27), which falls within the range of previously reported migration rates (between 10.3% and 23.6%) when followed up for a similar duration. [16,21,23] It is interesting to note that the displaced stents in this study were all located at the distal end of the ureter, which may be due to the severe compression of the distal ureteral stenosis. This can cause uneven force on the stent, leading to its migration.…”

Section: Discussionmentioning

confidence: 97%

“…Regardless of the cause of ureteral stricture, timely relief of obstruction can help to protect kidney function. [21] Although conventional double-J stents are effective, they have limitations. Chen et al [22] conducted a study comparing the safety and efficacy of conventional and metal stents, and found that metal stents demonstrated a higher patency rate at 6 months (100% vs 83.8%) and 1 year (91.7% vs 40.0%) than conventional stents.…”

Section: Discussionmentioning

confidence: 99%

Allium ureteral stent for the treatment of malignant ureteral obstruction: A median term study

Wang²,

Tang³

et al. 2023

Medicine

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This study aimed to assess the safety and efficacy of Allium ureteral stents for the maintenance therapy of malignant ureteral obstruction (MUO). Clinical data of 25 patients (27 sides) with ureteral obstruction caused by a malignant tumor from December 2018 to December 2021 were retrospectively analyzed. Preoperative ultrasonography and computed tomography urography indicated hydronephrosis and MUO. Allium ureteral stents were placed using a retrograde or antegrade approach. Therapeutic effects and complications were recorded. The Wilcoxon signed-rank test was used to compare continuous variables between the preoperative and the last follow-up. A total of 25 patients (27 sides) were included in this study. After a follow-up time of 18 (11–29) months, the width of hydronephrosis [1.6 (1.0–2.2) cm vs 2.6 (1.2–3.3) cm, P = .000], glomerular filtration rate [83.8 (58.1–86.4) mL/minutes/1.73 m2 vs 74.5 (56.8–79.1) mL/minutes/1.73 m2, P = .001] and score of ureteral stent symptoms questionnaire [77 (76–79) vs 100 (98–103), P = .000] was significantly improved. Stent migration occurred in 3 of the 25 patients within 3 months after surgery. All patients with complications were followed up for at least 6 months after stent adjustment or exchange, and no other complications were found. Two patients died because of malignant complications. The stent patency rate was 88.9% (24/27) after the first operation, and 100% (27/27) after complications were treated. The Allium ureteral stent is safe and effective for the maintenance therapy of MUO, which can dramatically relieve the symptoms of patients. Stent migration is a major complication that can be resolved by endoscopic adjustment.

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“…The overall surgical success rate was 73.2% over a follow-up of 15 months. [20] Furthermore, covered metallic ureteral stent was originally used in treating malignant ureteral strictures, however, it also works well in benign and iatrogenic ureteral strictures, which may be caused by retroperitoneal fibrosis, ureteroscopic lithotripsy, and ureteroileal anastomotic stenosis. [5][6][7]21,22] Nevertheless, whether or not it can be used for the long-term maintenance treatment of recurrent UPJO has not been investigated.…”

Section: Discussionmentioning

confidence: 99%

Long-term maintenance treatment of recurrent ureteropelvic junction obstruction with covered metallic ureteral stent

Tang

Wang

et al. 2023

Medicine

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Whether or not the covered metallic ureteral stent can be used as maintenance treatment for recurrent ureteropelvic junction obstruction (UPJO) after pyeloplasty is unknown. Therefore, this study aims to analyze its feasibility. We retrospectively analyzed the records of 20 patients with recurrent UPJO who were treated with the covered metallic ureteral stents from March 2019 to June 2021 at our institution. Then, we assessed their renal function, stent patency and stent-related quality of life by the blood creatinine, renal ultrasound (or computed tomography), and the Chinese version of the ureteral symptom score questionnaire (USSQ). The last follow-up mean blood creatinine dropped from 0.98 ± 0.22 to 0.91 ± 0.21 mg/dL ( P = .04), and the median renal pelvic width was reduced from 3.25 (3.10) to 2.00 (1.67) cm ( P = .03) compared with the preoperative conditions. Meanwhile, the last follow-up mean USSQ total score of the covered metallic ureteral stent among the 16 patients with preoperative indwelling double-J ureteral stent was 78.56 ± 14.75, significantly lower than the preoperative USSQ total score, which was 102.25 ± 5.57 ( P < .001). During the median duration of follow-up of 27.00 (18.00) months, 85% (17/20) of patients maintained unobstructed drainage from the renal pelvis to the ureter. Stent-related complications occurred in 7 patients, 3 of which failed because of complications, including stent migration (1 patient), stent encrustation (1 patient), and stent-related infection (1 patient). The covered metallic ureteral stent is feasible for the long-term maintenance treatment of recurrent UPJO after pyeloplasty.

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Self-expanding metal ureteral stent for ureteral stricture: Experience of a large-scale prospective study from a high-volume center - Cross-sectional study

Cited by 15 publications

References 23 publications

Allium covered metal stent for treatment of malignant ureteral obstruction

Allium covered metal stent for treatment of malignant ureteral obstruction

Allium ureteral stent for the treatment of malignant ureteral obstruction: A median term study

Long-term maintenance treatment of recurrent ureteropelvic junction obstruction with covered metallic ureteral stent

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