Subscribe to RSS
DOI: 10.1055/s-2008-1077447
© Georg Thieme Verlag KG Stuttgart · New York
Endoscopic ultrasound-guided ureterosigmoidostomy in malignant ureteral obstruction: description of a new method
Publication History
submitted 9 April 2008
accepted after revision 26 May 2008
Publication Date:
30 July 2008 (online)
![](https://www.thieme-connect.de/media/endoscopy/200809/lookinside/thumbnails/10.1055-s-2008-1077447-1.jpg)
Introduction
Malignant ureteral obstruction is a late and potentially terminal complication of pelvic malignancies such as bladder, colon, and uterine cancer [1]. Traditionally, palliation of unresectable malignant obstruction takes place with percutaneous nephrostomy, endoscopic stenting, or a combination of both, which are methods known to improve renal function and quality of life [2]. Although these techniques of urinary diversion are routinely carried out by urologists, only a fraction of patients benefit from conversion to internal drainage. Unlike their counterparts of the gastrointestinal and biliary tract, palliation of malignant extrinsic compression of the ureter with endoprosthesis is often unsuccessful, with a reported failure rate of approximately 60 % [3]. We describe a new technique, endoscopic ultrasound (EUS)-guided ureterosigmoidostomy, which aimed to relieve a malignant ureteral obstruction of a poor surgical candidate in whom prior uroendoscopic stent insertion had failed.
References
- 1 Jeong I G, Han K S, Joung J Y. et al . The outcome with ureteric stents for managing non-urological malignant ureteric obstruction. BJU Int. 2007; 100 1288-1291
- 2 Markowitz D M, Wong K T, Laffey K J. et al . Maintaining quality of life after palliative diversion for malignant ureteral obstruction. Urol Radiol. 1989; 11 129-132
- 3 Docimo S G, Dewolf W C. High failure rate of indwelling ureteral stents in patients with extrinsic obstruction: experience at 2 institutions. J Urol. 1989; 142 277-279
- 4 Shekarriz B, Shekarriz H, Upadhyay J. et al . Outcome of palliative urinary diversion in the treatment of advanced malignancies. Cancer. 1999; 85 998-1003
- 5 Romero F R, Broglio M, Pires S R. et al . Indications for percutaneous nephrostomy in patients with obstructive uropathy due to malignant urogenital neoplasias. Int Braz J Urol. 2005; 31 117-124
- 6 Aravantinos E, Anagnostou T, Karatzas A D. et al . Percutaneous nephrostomy in patients with tumors of advanced stage: treatment dilemmas and impact on clinical course and quality of life. J Endourol. 2007; 21 1297-1302
E. B. da Silveira, MD
Department of Gastroenterology
Portland VA Medical Center
3710 SW US Veterans Hospital Boulevard MC
P3GI Portland
Oregon 97239
USA
Fax: +1-503-220-3426
Email: eda_silveira@hotmail.com