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Use of a long-term metal stent in complex uretero-ileal anastomotic stricture.

Kabir MN, Bach C, Kachrilas S, Zaman F, Junaid I, Buchholz N, Masood J - Arab J Urol (2011)

Bottom Line: This is technically challenging and has potential significant morbidity for the patient.We describe the technique and potential advantages of this minimally invasive method.This minimally invasive treatment option is of interest, as in contrast to other stents, it does not require routine change, and is resistant to corrosion and urothelial ingrowth, hence ensuring ease of exchange or removal if required.

View Article: PubMed Central - PubMed

Affiliation: Endourology and Stone Services, Barts and The London NHS Trust, West Smithfield, London EC1A 7BE, UK.

ABSTRACT
Uretero-ileal anastomotic stricture is a potentially serious late complication after ileal conduit formation, with a reported incidence of 3-9%. The standard management technique is open surgical revision of the anastomosis with reimplantation of the affected ureter. This is technically challenging and has potential significant morbidity for the patient. Advances in endourological techniques now offer a variety of less-invasive treatment options, like balloon dilatation or laser ureterotomy followed by stent insertion. What happens when such open and minimally invasive techniques fail? Recently, using a combined antegrade and retrograde approach, we inserted a novel, semi-permanent, dual-expansion thermo-expandable metallic alloy stent across a recurrent ileal-ureteric stricture. We describe the technique and potential advantages of this minimally invasive method. This minimally invasive treatment option is of interest, as in contrast to other stents, it does not require routine change, and is resistant to corrosion and urothelial ingrowth, hence ensuring ease of exchange or removal if required.

No MeSH data available.


Related in: MedlinePlus

Nephrostogram to visualize the position of the stricture marked with a circle.
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f0005: Nephrostogram to visualize the position of the stricture marked with a circle.

Mentions: Under general anaesthesia, the patient is placed supine as for percutaneous nephrolithotomy (PCNL), with a 10–15° tilt of the ipsilateral trunk. Percutaneous renal access is obtained by standard PCNL techniques, and a nephrostogram taken to confirm the position and length of the stricture (Fig. 1). A guidewire is inserted via the percutaneous tract through the stricture and externalised through the conduit using the flexible cystoscope, leaving a ‘through and through wire’.


Use of a long-term metal stent in complex uretero-ileal anastomotic stricture.

Kabir MN, Bach C, Kachrilas S, Zaman F, Junaid I, Buchholz N, Masood J - Arab J Urol (2011)

Nephrostogram to visualize the position of the stricture marked with a circle.
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4150572&req=5

f0005: Nephrostogram to visualize the position of the stricture marked with a circle.
Mentions: Under general anaesthesia, the patient is placed supine as for percutaneous nephrolithotomy (PCNL), with a 10–15° tilt of the ipsilateral trunk. Percutaneous renal access is obtained by standard PCNL techniques, and a nephrostogram taken to confirm the position and length of the stricture (Fig. 1). A guidewire is inserted via the percutaneous tract through the stricture and externalised through the conduit using the flexible cystoscope, leaving a ‘through and through wire’.

Bottom Line: This is technically challenging and has potential significant morbidity for the patient.We describe the technique and potential advantages of this minimally invasive method.This minimally invasive treatment option is of interest, as in contrast to other stents, it does not require routine change, and is resistant to corrosion and urothelial ingrowth, hence ensuring ease of exchange or removal if required.

View Article: PubMed Central - PubMed

Affiliation: Endourology and Stone Services, Barts and The London NHS Trust, West Smithfield, London EC1A 7BE, UK.

ABSTRACT
Uretero-ileal anastomotic stricture is a potentially serious late complication after ileal conduit formation, with a reported incidence of 3-9%. The standard management technique is open surgical revision of the anastomosis with reimplantation of the affected ureter. This is technically challenging and has potential significant morbidity for the patient. Advances in endourological techniques now offer a variety of less-invasive treatment options, like balloon dilatation or laser ureterotomy followed by stent insertion. What happens when such open and minimally invasive techniques fail? Recently, using a combined antegrade and retrograde approach, we inserted a novel, semi-permanent, dual-expansion thermo-expandable metallic alloy stent across a recurrent ileal-ureteric stricture. We describe the technique and potential advantages of this minimally invasive method. This minimally invasive treatment option is of interest, as in contrast to other stents, it does not require routine change, and is resistant to corrosion and urothelial ingrowth, hence ensuring ease of exchange or removal if required.

No MeSH data available.


Related in: MedlinePlus