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Subcutaneous nephro-vesical bypass in the treatment of ureteral obstruction

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Author(s): Zhi-guo YANG | Hai-dong ZHAO | Yong-jiang LIU | Wei CHEN | Wei-ping SONG | Yong-hong WANG

Journal: Medical Journal of Chinese People's Liberation Army
ISSN 0577-7402

Volume: 36;
Issue: 4;
Start page: 397;
Date: 2011;
Original page

Keywords: subcutaneous; bypass; ureteral obstruction; neoplasm stents; percutaneous

ABSTRACT
Objective To sum up the experiences on treating ureteral obstruction in patients with terminal tumor by subcutaneous nephro-vesical bypass.Methods A total of 16 subcutaneous prosthetic ureters were percutaneously implanted into 12 patients(8 unilateral and 4 bilateral) for the treatment of ureteral obstruction due to terminal tumor.The tube was inserted into the renal pelvis,tunnelled subcutaneously and introduced in the bladder through a small suprapubic incision.Serum creatinine and renal ultrasonography were evaluated during follow up.Results No operative or immediate postoperative death occurred.The patients were alive with the prosthesis without occurrence of encrustation,infection,or obstruction,and the renal function was normal.The serum creatinine level decreased significantly from 232.2±18.1μmol/L(preoperation) to 115.2±17.1μmol/L(postoperation).Conclusions The subcutaneous urinary diversion using Ureteral Bypass Set is an efficient and minimally invasive way to bypass malignant obstructions of the ureters that otherwise would necessitate permanent nephrostomy drainage.With the operation patients may get a better quality of life due to increased independence and activity during their final stage of life.
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