Wallstents for the treatment of extrinsic malignant ureteral obstruction: midterm results.

Abstract

To test the clinical efficacy of metal stents in the treatment of malignant ureteral obstruction and to maximize the effectiveness of the method. Fifty-four malignant stenoses of the ureter were treated in 40 patients by implantation of a self-expandable permanent endoluminal stent (SPES). The mean follow-up time was 10.5 months (range, 1-44 months). Recanalization was possible in all but one ureter. Fifty-one ureters were kept sufficiently open during the follow-up period. Fifty-one percent needed no further intervention, whereas 49% needed reintervention to reestablish patency. Three ureters in the latter group finally had to be abandoned. The primary patency after 12 months was 31% according to the Kaplan-Meier estimation. The survival rates of the patients were 40% after 12 months and 22% after 24 months and were unrelated to stent placement. Since no major complications occurred and hydronephrosis and its sequelae could be prevented in most cases during the observation period, the authors conclude that the implantation of a SPES into the ureter is a safe and effective method for the palliative treatment of tumor-associated ureteral strictures.