Efficacy of two operation methods in relieving malignant ureteral obstruction：a comparative analysis

Abstract:

Objective To summarize the current clinical treatment regimens and experience for malignant ureteral obstruction（MUO），to clarify the clinical application scope of percutaneous nephrostomy（PN） and ureteral stenting（US） in managing MUO，and to investigate the efficacy of these two operation methods in relieving renal impairment due to MUO.Methods A retrospective analysis was performed for 76 patients who were diagnosed with MUO in Department of Urology，The First Affiliated Hospital of Chongqing Medical University，from January 2021 to May 2023 and were screened according to strict inclusion and exclusion criteria，and then they were randomly divided into PN group with 22 patients and US group with 54 patients. The two groups were compared in terms of baseline characteristics，perioperative data，and half-year follow-up data，and SPSS 21.0 was used for data analysis.Results There were significant differences between the two groups in sex（P=0.017），degree of hydronephrosis at the operated side（P=0.000），urea nitrogen（P=0.002） and serum creatinine（P=0.003） 3 days before surgery，and urea nitrogen（P=0.017） and blood creatinine（P=0.005） 1 day after surgery. There was no significant difference in renal function between the two groups at 3 days and 6 months after surgery.Conclusion MUO is often observed in cervical cancer，followed by bladder cancer and colorectal cancer. US is suitable for patients with obstruction or mild hydronephrosis，chronic ureteral obstruction，and mild renal impairment，and it can be considered the preferred choice for relieving ureteral obstruction. PN is typically used for the treatment of patients with moderate to severe hydronephrosis，severe renal impairment，or acute renal insufficiency caused by MUO，and it can be used as an alternative in case of the failure of US.