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微创泌尿外科杂志  2020, Vol. 9 Issue (5): 289-293    DOI: 10.19558/j.cnki.10-1020/r.2020.05.001
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ALLIUM®覆膜输尿管支架治疗输尿管狭窄7例报告
高宇1, 王保军1, 徐衍盛1, 杜青山1, 李世超1, 彭程1, 张旭1, 马鑫1
1中国人民解放军总医院泌尿外科 100853 北京
Initial experience of ALLIUM® stent application in ureteral stricture: 7 cases report
GAO Yu1, WANG Baojun1, XU Yansheng1, DU Qingshan1, LI Shichao1, PENG Cheng1, ZHANG Xu1, MA Xin1
1Department of Urology, Chinese PLA General Hospital, Beijing 100853, China
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摘要 目的:评估ALLIUM®覆膜输尿管支架(URS)治疗输尿管狭窄的安全性和有效性。方法:2019年9–12月收治7例输尿管狭窄患者行ALLIUM®覆膜URS置入术。其中3例为宫颈癌术后放疗致单侧或双侧输尿管狭窄,2例为孤立肾先天性肾盂输尿管连接处梗阻(UPJO)术后狭窄复发,1例为输尿管镜激光碎石术后单侧输尿管狭窄,1例为孤立肾合并盆腔脂肪增多症致输尿管壁内段狭窄。均采用URS(10~100 mm或10~120 mm规格),全部支架经尿道逆行置入,先行球囊扩张,再置入URS。其中2例为双侧支架置入,1例单侧输尿管置入叠放2根URS。共置入10根,中位随访时间4个月(4~7个月)。结果:6例术后肾积水即刻明显缓解,无尿外渗,无腰部胀痛,无血尿和泌尿系感染,1例出现轻度盆腔积液,所有患者通过腹部X线平片和CT证实对狭窄病变的完全支撑。中位术后住院时间3 d。随访中2例观察到支架移位,其中1例术后2个月支架脱落至膀胱内,后通过膀胱镜安全移除。另1例支架随肾结石下移后出现输尿管不完全梗阻,予以输尿管镜激光碎石处理。其余支架在随访中位置良好,患者未出现腰痛、血尿、尿路刺激症等不适。结论:短期结果显示ALLIUM®覆膜URS治疗输尿管狭窄安全有效,但仍需更多的病例和更长时间的随访证实疗效。
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高宇
王保军
徐衍盛
杜青山
李世超
彭程
张旭
马鑫
关键词 ALLIUM&#x000ae覆膜输尿管支架球囊扩张输尿管狭窄    
AbstractObjective: To evaluate the safety and effectiveness of the new ALLIUM ureteral stent in the treatment of ureteral stricture. Methods: A total of 7 patients with ureteral stricture undergoing ALLIUM ureteral stent placement in our hospital from September to December 2019 were enrolled. Among them, there were 3 cases of unilateral or bilateral ureteral stricture due to postoperative radiotherapy for cervical cancer, 2 cases of recurrent ureteral stricture after pyloplasty of ureteropelvic junction obstruction of solitary kidney, and one case of unilateral ureteral stricture after ureteroscopic lithotripsy. There was one case of solitary kidney with pelvic lipomatosis leading to ureteral stricture. In all cases, we used a 30 Fr, 10 cm or 12 cm self-expanding ALLIUM ureteral stent. All stents were transurethrally placed following balloon dilatation. Two cases were implanted with bilateral ALLIUM stents, and one case was implanted with two ALLIUM stents in unilateral ureter. A total of 10 ureteral stents were placed, and the median follow-up time was 4 months (range 4-7 months). Results: Preoperative hydronephrosis in 6 cases was significantly relieved, and no cases had urine extravasation, lumbago, hematuria and urinary tract infection. One case had mild pelvic effusion, and all patients had complete stenosis expansion verified by radiography and CT. The median postoperative hospital stay was 3 days. Trans-location of stents was observed in 2 cases during the follow-up. The stent fell into the bladder two months after the operation in one case, and safely removed by the endoscopic maneuver. The incomplete ureteral obstruction occurred due to kidney stone incarceration in one case. The rest stents were in a good position during follow-up, and the patients did not complain lower back pain, hematuria, and urinary tract irritation signs. Conclusion: The short-term results showed that the new ALLIUM ureteral stent is safe and effective in treating ureteral stricture, but more cases and longer follow-up are needed to validate the efficacy.
Key wordsALLIUM&#x000ae    urinary tract stent    balloon dilatation    ureteral stricture
收稿日期: 2020-04-22     
ZTFLH:  R693  
通讯作者: 马鑫,urologist@foxmail.com   
引用本文:   
高宇, 王保军, 徐衍盛, 杜青山, 李世超, 彭程, 张旭, 马鑫. ALLIUM®覆膜输尿管支架治疗输尿管狭窄7例报告[J]. 微创泌尿外科杂志, 2020, 9(5): 289-293.
GAO Yu, WANG Baojun, XU Yansheng, DU Qingshan, LI Shichao, PENG Cheng, ZHANG Xu, MA Xin. Initial experience of ALLIUM® stent application in ureteral stricture: 7 cases report. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2020, 9(5): 289-293.
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