Comparison of single and tandem ureteral stenting for malignant ureteral obstruction: a prospective study of 104 patients

Liu, Kao–Lang; Lee, Bo-Ching; Ye, Jian-De; Chang, Yu-Hsuan; Chang, Chin‐Chen; Huang, Kuo-How; Lee, Yuan-Ju; Chang, Yu‐Cheng

doi:10.1007/s00330-018-5560-6

Cited by 26 publications

(25 citation statements)

References 47 publications

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“…In case of stent failure, the most common derivation offered to the patient was PCN. 1,15,16,19,21 Among the 150 patients in our study, the retrograde stenting by endoscopy was unsuccessful in 15 patients (10.0%) and the rate of failure was in agreement with these data. However, performing endoscopy with simultaneous PCN allowed anterograde stenting in all cases of the retrograde stenting failure.…”

Section: Dovepresssupporting

confidence: 88%

“…The permeability was more than 80% at 3 months and 50% to 100% at 6 months. 8,14,21,23 In our study, stent failure occurred in only 11.1% of patients fitted with tandem stents and the results seemed better than in the other series, but our tandem stents were 8F reinforced stents. Several authors observed a decrease in overall survival in case of tandem failure.…”

Section: Dovepresscontrasting

confidence: 60%

“…In other studies, tandem attempts failure was 5% to 27.2%. 14 , 17 , 21 Several studies showed the benefits of tandem stents but the stents used were variable, and the stents were not reinforced. The permeability was more than 80% at 3 months and 50% to 100% at 6 months.…”

Section: Discussionmentioning

confidence: 99%

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10-Year Experience with Reinforced Ureteral Stents for Malignant Ureteral Obstruction

Vogt¹,

Blanchet²

2021

RRU

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Introduction Malignant ureteral obstruction (MUO) hinders the management of malignant diseases. Indwelling stent is a common method to release renal obstruction, but stent failure with obstruction is frequent. The studies conclude that stent obstruction divides survival by 2 or even 4. We carried out the present study in order to evaluate drainage efficiency and overall survival by using stents with distinctive degrees of stiffness. Materials and Methods We performed an analysis of 156 patients with MUO drainage at a single institution from June 2009 to June 2019. Results Of the 156 patients, 128 (82.1%) died with a mean survival time of 15.3 ± 14.4 months after the first ureteral stent procedure (USP). In order to study stent failure and overall survival, the patients were divided into 3 groups. Group 1 with patients died soon after only one USP (n=37). Group 2 with patients had more than one USP and no obstruction (n=41). Patients in Group 3 had more than one USP and at least one stent obstruction (n=62). During the study period, 556 USPs were analysed separately. The stent failure with obstruction occurred in 23.0% (128/556) of USP at a mean of 4.4 ± 3.6 months. In case of stent failure, a progressive choice of stents was shaped to overcome each failure by focusing on the criterion of increasingly stiff stents. Patients in Group 1 died soon at mean of 4.9 ± 4.8 months. The mean survival time of patients in Groups 2 and 3 were, respectively, 19.4 ± 11.2 and 21.5 ± 16.3 months (P = 0.19). Conclusion MUO is a serious disease but this study is the first to prevent survival rate from falling by choosing the stent stiffness suitable for the patient. The active detection of stent failure has been shown to be essential for preserving survival.

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Section: Dovepresssupporting

confidence: 88%

Section: Dovepresscontrasting

confidence: 60%

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10-Year Experience with Reinforced Ureteral Stents for Malignant Ureteral Obstruction

Vogt¹,

Blanchet²

2021

RRU

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“…Liu et al indicated that there was a paucity of data regarding the use of reinforced polymeric stent in patients with MUO. 14 However, some studies provide information about the stent. Docimo at al reported 45.8% of stent failure at Day 30 with silicone stents, 4 while 16% of failure at 3.2 months was observed by Jeong et al with an Endo-Sof, 15 23% with a Percuflex at 5.9 months by Rosevear et al 16 and 34% at a median time of 21 days with Percuflex HydroPlus Coating by Kamiyama et al 17 Clinical efficacy of the reinforced polymeric stent is generally presumed to outperform the regular polymeric stent and Liu et al reported a mean patency at 5.8 months with reinforced Urosoft 7F.…”

Section: Stent Failurementioning

confidence: 99%

Analysis of Ureteral Tumour Stents for Malignant Ureteral Obstruction: Towards Reshaping an Optimal Stent

Vogt¹,

Blanchet²

2021

RRU

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Introduction: Ureteral obstruction hinders the management of malignant diseases. Adequate stent placement does not necessarily guarantee renal decompression. The stent stiffness may play a major role to maintain patency. We carried out the present study in order to evaluate drainage efficiency by using stents with distinctive degrees of stiffness and to identify the physical factors that could prevent obstruction of the stent in patients with malignant ureteral obstruction (MUO). Materials and Methods:We performed an analysis of 150 patients with MUO drainage at a single institution from June 2009 to June 2019. A progressive choice of stents was shaped to overcome each failure by focusing on the criterion of increasingly stiff stents. Results: During the study period, 556 ureteral stent procedures (USP) were analysed separately. The stent failure with obstruction occurred in 23.0% (128/556) of USP at a mean of 4.4±3.6 months and depended on the type of stent. Stent failure occurred in 34.2% (70/205) of Vortek ® stents, in 42.9% (15/35) of Urosoft stents, in 15.4% (39/254) of Superglide or ureteral catheters and in 6.5% (4/62) of tandem stents. No significant differences were found between Vortek ® and Urosoft stents regarding stent failures, but there were significant differences between Superglide or Tandem stents and Vortek ® or Urosoft stents (p<10 −7 ). The study demonstrated that ureteral stent obstruction significantly decreased with a larger lumen or a stiffer stent (p<10 −7 ). Conclusion:In the present study, Superglide and tandem stents were the best stents against stent failure, and the lumen and the stiffness of the stent have been shown to be critical factors in controlling patency. The results suggest that the lumen seems more important than the stiffness, and the stiffness would be the only means of keeping the lumen intact. Future stents for MUO should integrate the importance of the lumen of the stent.

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“…Moreover, measures are also taken to minimize further urologic intervention, hospitalization and adverse impacts of quality of life (QoL). 4,5 Percutaneous nephrostomy (PCN) is minimally invasive ultrasonography-guided procedure 6 while double-J ureteral stenting (DJS) becomes choice for obstruction on large-sized ureteral stone. Like any other interventional procedure, there are chances of post-operative complications.…”

Section: Introductionmentioning

confidence: 99%

Double-J Stenting Versus Percutaneous Nephrostomy; Postoperative Complications in Management of Ureteral Obstruction

Saeed

Hussain

Kanjoo

et al. 2020

APMC

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Background: Ureteral obstruction is a common surgical problem and managed by stent insertion or percutaneous nephrostomy. However, there is still confusion that which procedure is better in terms of the complications. Objective: To compare the efficacy of double J stenting and percutaneous nephrostomy for ureteral obstruction in terms of post-operative complications. Study Design: Randomized Clinical Trial.

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Comparison of single and tandem ureteral stenting for malignant ureteral obstruction: a prospective study of 104 patients

Cited by 26 publications

References 47 publications

10-Year Experience with Reinforced Ureteral Stents for Malignant Ureteral Obstruction

10-Year Experience with Reinforced Ureteral Stents for Malignant Ureteral Obstruction

Analysis of Ureteral Tumour Stents for Malignant Ureteral Obstruction: Towards Reshaping an Optimal Stent

Double-J Stenting Versus Percutaneous Nephrostomy; Postoperative Complications in Management of Ureteral Obstruction

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