WALLSTENTS FOR THE TREATMENT OF EXTRINSIC MALIGNANT URETERAL OBSTRUCTION - MIDTERM RESULTS

PURPOSE: To test the clinical efficacy of metal stents in the treatmen t of malignant ureteral obstruction and to maximize the effectiveness of the method. MATERIALS AND METHODS: Fifty-four malignant stenoses of the ureter were treated in 40 patients by implantation of a self-expa ndable permanent endoluminal stent (SPES). RESULTS: The mean follow-up time was 10.5 months (range, 1-44 months). Recanalization was possibl e in all but one ureter. Fifty-one ureters were kept sufficiently open during the follow-up period. Fifty-one percent needed no further inte rvention, whereas 49% needed reintervention to reestablish patency. Th ree ureters in the latter group finally had to be abandoned. The prima ry patency after 12 months was 31% according to the Kaplan-Meier estim ation. The survival rates of the patients were 40% after 12 months and 22% after 24 months and were unrelated to stent placement. CONCLUSION : Since no major complications occurred and hydronephrosis and its seq uelae could be prevented in most cases during the observation period, the authors conclude that the implantation of a SPES into the ureter i s a safe and effective method for the palliative treatment of tumor-as sociated ureteral strictures.