VYUŽITÍ EXTRAANATOMICKÉHO STENTU (EAS) U PACIENTŮ S POKROČILÝM MALIGNÍM ONEMOCNĚNÍM.

Aim: Ureteral obstruction is a frequent complication in patients with malignant diseases. The most frequently used solutions are a ureteral stent, nephrostomy or open surgical intervention. An extra-anatomic stent (EAS) represent an alternative method for urinary diversion in patients with advanced malignancy and short life expectancy. The aim of this paper is to verify the efficacy of using an EAS for urinary diversion and to evaluate the quality of life (QoL) following the procedure. Methods: The study included 11 patients (8 men and 3 women), with a mean age of 64.5 years (38-80 years). Five patients with advanced bladder carcinoma, three patients suffered from locally advanced prostate cancer, one patient with locally advanced cervical cancer and two patients with generalized colorectal cancer. In 9 cases, patients received diversion using a uros-tomy bag, in 2 cases EAS was used as a bilateral nephrovesical bypass. QoL was evaluated using the King's Health Questionnaire before and 4 weeks after treatment. The results were evaluated using the Wilcoxon test with a significance level of 0.05. Results: During a mean follow-up period of 40 weeks (8-55 weeks), QoL after the EAS insertion increased significantly for all parameters. Hydronephrosis was resolved by EAS insertion in 10 cases and improved in one patient. Preoperative serum creatinine level (186,6 ± 64,67 µmol/1) decreased significantly postope-ratively (106 ± 24,49 µmol/1). Conclusion: EAS represents a promising treatment alternative for dealing with ureteral obstruction in the terminal stage of malignant diseases. The procedure is not difficult and has good functional results, with a significant increase in the quality of life for patients. [ABSTRACT FROM AUTHOR]