26. Đánh giá kết quả đặt stent kim loại tự giãn rộng điều trị hẹp niệu quản tại Bệnh viện Đại học Y Hà Nội

Abstract

Ureteral strictures could be a chronic illness that leads to severe side effects and poor quality of life. Ureteral strictures can be treated by several approaches including placement of ureteral stents (URSs) in patients. We evaluate the long-term results of the Allium ureteral stent as a curative treatment of ureteral strictures. We prospectively collected data on all patients who underwent Allium URSs positioning for different types of stenosis at the Department of Urology, Hanoi Medical University Hospital between February 2019 and July 2023. The clinical, radiological, and perioperative parameters were retrieved and analyzed. The primary outcome was stricture resolution rates following stent removal. Our study included 135 patients, 82 male (60.7%) and 53 female (39.3%) with a mean age of 47.9 ± 15.2 years old (range from 19 to 85). About the etiology of strictures, 105 (77.8%) were secondary to ureteroscopy or impacted stones; 14 (10.4%) were secondary to pyelus-ureteral stenosis plasty and 8 (5.9%) after pelvic surgery. The median operating time was 37.2 ± 14.3 min (15 - 90), and the median length of strictures was 2.17 ± 0.64cm (0.5 - 4). There was no intraoperative or perioperative major complication recorded. In total, 87 (64.4%) stent removal was performed after the mean indwelling time of the Allium stent was 24.38 ± 6.43 months (2 - 39). The overall success rate was 83.9% (73/87) with a median follow-up of 9.83 ± 5.67 months (1 - 47). Among patients with failure (14 pts, 16.1%), 10 (71.4%) presented with recurrent ureteral strictures; among them, 9/10 were patients with a stricture length between 2 and 4cm; 4 (28.6%) patients with pyelus - ureteral junction stenosis experienced stent migration. The Allium ureteral stent could be considered as a feasible and attractive treatment of ureteral strictures due to its minimal invasiveness and the success rate is comparable with surgical repair. Further analysis are necessary to better define the role of the Allium stent in the treatment of ureteral strictures.