CU 53. Application of subcutaneous nephrovesical bypass in patients with ureter obstruction

Purpose: To improve the quality of life of patients with palliative definitive percutaneous nephrostomy, we prospectively evaluated a subcutaneous nephrovesical bypass carried out in patients with ureter obstruction.

Patients and Methods: A series of 36 patients with advanced cancer receiving 45 subcutaneous nephrovesical bypass tubes (BARD). Uronephrosis range from 1.8-5.2 cm, serum creatinine 73-760 μmol/L, GFR19-26 mL/min, obstruction was proved to be complete by retrograde pyelography. The nephrovesical stents were inserted utilizing percutaneous access to both the kidney and bladder, a subcutaneous tunnel was created between the two sites. B-us, KUB, serum creatinine test and GFR were carried out 72 hours after operation.

Results: Urinary diversion operations were successful in 36 patients, uronephrosis range from 0-1.8 cm, all stents were in position, serum creatinine 72-173 μmol/L, GFR 25-40 mL/min after the operation, the bypass has functioned well in 45 stents during 67 to 481 days of follow up.

Conclusions: Subcutaneous nephrovesical bypass can protect renal function suffering from ureteral obstruction by simple and minimum invasive operation; also it can reduce complications caused by percutaneous nephrostomy and improve quality of patient's life.