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Metal stents: a new treatment of malignant ureteral obstruction
G A Barbalias1, D Siablis, E N Liatsikos
1Department of Urology, University of Patras, School of Medicine, Greece.
Purpose:
We report our experience with the use of metallic self-expandable and balloon expandable stents for the treatment of malignant ureteral obstruction.
Materials And Methods:
We treated 12 consecutive patients with malignant ureteral obstruction, for a total of 14 ureters with stents placed. We placed metallic balloon expandable stents in 6 patients and self-expandable metallic stents in the remaining 6. Mean patient age was 65 years and mean followup was 9 months (range 8 to 16).
Results:
Of the ureters 11 were patent without any additional manipulations during followup of 8 to 16 months. Secondary interventions were needed in 3 cases because of obstructive urothelial hyperplastic reaction, tumor ingrowth and local recurrence of the primary cancer invading the upper end of the stent. Two patients died 2 and 10 months after placement of the stent.
Conclusions:
Both types of metal stents have advantages and disadvantages that must be balanced against each other when choosing the ideal device for the treatment of obstruction. Implantation of a metal self-expanding or balloon expanding stent is safe and effective for the palliative treatment of malignant ureteral obstruction in late stage cancer patients.