[Endourologic treatment of the upper urinary tract obstruction in the advanced cancer patients].
88 cancer patients with an upper urinary tract obstruction were endourologically treated. The obstructions were caused by metastasis or invasion of cancer in all patients. First we tried to insert a ureteral stent catheter (STENT). When it failed percutaneous nephrostomy (PCN) was performed. Initially 69 and 19 patients were treated by STENT and PCN, respectively. Of 69 patients with STENT, 13 received PCN later. The average survival of all patients after treatment was 5.7 months. About 60% of the patients were discharged from hospital. The patients treated by STENT and PCN survived for 5.4 months and 6.7 months in average. The STENT was changed 1.8 times on the average in all patients. 79% of the patients who had been treated by STENT experienced only one or two times of STENT changes before dying. Patency period of inserted STENT was studied. On the average the STENT occluded after 72.4 days. The patent period of STENT was longer in the patients group of prophylactic STENT insertion for hydronephrosis. The period was shorter in the patients who showed gross hematuria at the time of surgery. Patent period of STENT was not related to STENT size. Although survival was not so long, over 60% of the patients were able to return to their homes. Endourologic treatment of urinary obstruction was performed in only 6 patients in 1985. The number of such cases has been increasing gradually and currently 20 patients are treated annually. It is supposed that there are many more cancer patients with urinary tract obstruction in their end-stage.(ABSTRACT TRUNCATED AT 250 WORDS)
Department of Urology, Toranomon Hospital.
K
K
Inoue
M
M
Sakai
M
M
Kanou
H
H
Oda
K
K
Kitahara
M
M
Kanemura
M
M
Osaka
M
M
Yokoyama
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000209:etiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D015607:Stents; D014513:Ureter; D014517:Ureteral Obstruction / Q000209:etiology / Q000628:therapy*