Use of nephrostomy tubes in ureteric obstruction from incurable malignancy.
Malignancy may produce ureteric obstruction. This obstruction may be relieved by inserting a nephrostomy tube. All 31 cases of malignant ureteric obstruction from a single institution were retrospectively analysed. The commonest indications for nephrostomy tube insertion were renal failure (87%) and flank pain with hydronephrosis (13%). The mean serum creatinine levels pre and post insertion were 481 and 170 micromol/l, representing significant improvement (p<0.01). The complication rate was 13%, relating to tube blockage or dislodgement. Survival of patients was significantly worse if their malignancy was not resectable or suitable for chemotherapy (p=0.01). However, incurable patients still survived for a mean of 232 days, and although 46% of this time was spent as an inpatient, it did not differ significantly from the inpatient rate of curable patients (31%, p=0.1). Nephrostomy tube insertion should be considered for all palliative cases of malignant ureteric obstruction.
Department of Urology, Craigavon Area Hospital, Craigavon, Co Armagh.
B
B
Little
K J
KJ
Ho
S
S
Gawley
M
M
Young
D000368:Aged; D000369:Aged, 80 and over; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000379:methods*; D010166:Palliative Care; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D014516:Ureteral Neoplasms / Q000150:complications; D014517:Ureteral Obstruction / Q000150:complications / Q000628:therapy*
D003404:Creatinine