Quality-of-Life Assessment After Palliative Interventions to Manage Malignant Ureteral Obstruction

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• 作者：Wayne Laurence Monsky ; Chris Molloy…
• 关键词：Quality of life ; Nephrostomy ; Nephroureteral stent ; Ureteral obstruction
• 刊名：CardioVascular and Interventional Radiology
• 出版年：2013
• 出版时间：October 2013
• 年：2013
• 卷：36
• 期：5
• 页码：1355-1363
• 全文大小：359KB
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• 作者单位：Wayne Laurence Monsky (1) (2)
  Chris Molloy (3)
  Bedro Jin (3)
  Timothy Nolan (2)
  Dayantha Fernando (2) (4)
  Shaun Loh (2)
  Chin-Shang Li (5)
  
  1. Department of Radiology, University of Washington Medical Center, 1959 Pacific Ave NE, Box 357115, Seattle, WA, 98195, USA
  2. Department of Radiology, University of California Davis Medical Center, Sacramento, CA, USA
  3. School of Medicine, University of California, Davis, Sacramento, CA, USA
  4. Department of Radiology, University of California, Irvine, Irvine, CA, USA
  5. Division of Biostatistics, Department of Public Health Sciences, University of California, Davis, Davis, CA
  
• ISSN：1432-086X

文摘

Purpose: Malignancies may cause urinary tract obstruction, which is often relieved with placement of a percutaneous nephrostomy tube, an internal double J nephro-ureteric stent (double J), or an internal external nephroureteral stent (NUS). We evaluated the affect of these palliative interventions on quality of life (QoL) using previously validated surveys. Methods: Forty-six patients with malignancy related ureteral obstruction received nephrostomy tubes (n?=?16), double J stents (n?=?15), or NUS (n?=?15) as determined by a multidisciplinary team. QoL surveys were administered at 7, 30, and 90?days after the palliative procedure to evaluate symptoms and physical, social, functional, and emotional well-being. Number of related procedures, fluoroscopy time, and complications were documented. Kruskal–Wallis and Friedman’s test were used to compare patients at 7, 30, and 90?days. Spearman’s rank correlation coefficient was used to assess correlations between clinical outcomes/symptoms and QoL. Results: Responses to QoL surveys were not significantly different for patients receiving nephrostomies, double J stents, or NUS at 7, 30, or 90?days. At 30 and 90?days there were significantly higher reported urinary symptoms and pain in those receiving double J stents compared with nephrostomies (P?=?0.0035 and P?=?0.0189, respectively). Significantly greater fluoroscopy time was needed for double J stent–related procedures (P?=?0.0054). Nephrostomy tubes were associated with more frequent minor complications requiring additional changes. Conclusion: QoL was not significantly different. However, a greater incidence of pain in those receiving double J stents and more frequent tube changes in those with nephrostomy tubes should be considered when choosing palliative approaches.