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Modified Supine Position for the Management of Malignant Ureteral Obstruction
| Content Provider | Semantic Scholar |
|---|---|
| Copyright Year | 2017 |
| Abstract | The treatment of ureteral obstruction due to advanced abdominal or pelvic malignancy is a therapeutic challenge. This type of obstruction is usually due to metastatic disease by direct tumor compression of the ureters (cervical bladder, prostate or colorectal), extrinsic compression from expansion of the retroperitoneal cavity (retroperitoneal soft tissue or sarcoma) or encasement of the ureters with metastatic lymph nodes [1]. The optimal management of such obstruction resulting from advanced malignancy remains unclear [2]. The finding of ureteral obstruction due to malignancy is an ominous sign with a resulting median survival of 3 to 7 months [3]. Progressive obstructive uropathy may likely lead to clinical manifestations, such as uremia, electrolyte imbalances and persistent urinary tract infections, if obstruction is not bypassed [4]. Percutaneous nephrostomy has been traditionally used to provide temporary or long-term urinary drainage for patients with impassable ureteric strictures. This procedure has major disadvantages for long-term use because there is a need for regular changes, the catheters often get dislodged and/or blocked, and the external drainage with catheter and bag often contributes to an impaired quality of life for the patients [5]. Managing extrinsic compression of the ureter by retrograde stenting is first-line therapy but involves a guarded decision because stent failure occurs in nearly half of the treated patients [6,7]. Because this high level of failure and the high rate of complications of permanent nephrostomy, our study proposes a novel position that allows easier stenting via combined and simultaneous antegrade and retrograde access of the obstruction. |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | http://medcraveonline.com/UNOAJ/UNOAJ-05-00172.pdf |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Bladder Tissue Body cavities Compression Electrolyte imbalance High-level programming language Intestinal Pseudo-Obstruction Liver Failure, Acute Malignant Childhood Central Nervous System Neoplasm Neoplasm Metastasis Neoplasms Nephrostomy (procedure) Patients Postoperative anesthesia care unit (PACU) Retroperitoneal Space Sarcoma Stenosis Stent, device Tract (literature) Upper urinary tract structure Uremia Ureter Ureteral obstruction Ureterolithiasis Urinary Bladder Urinary tract infection Urinary tract obstruction Urologic Diseases Urologic Neoplasms lymph nodes soft tissue |
| Content Type | Text |
| Resource Type | Article |
