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Malignant ureteric obstruction decompression: how much gain for how much pain? A narrative review

机译:恶性输尿管梗阻减压:多少痛苦的收益?叙述评论

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摘要

Over the last thirty years, the management of Malignant Ureteric Obstruction (MUO) has evolved from a single disciplinary decision to a multi-disciplinary approach. Careful consideration must be given to the risks and benefits of decompression of hydronephrosis for an individual patient. There is a lack of consensus of opinion as well as strong evidence to support the decision process. Outcomes that were identified amongst patients undergoing treatment for MUO included prognosis, quality of life (QOL), complications, morbidity and prognostication tools. A total of 63 papers were included. Median survival was 6.4 months in the 53 papers that stated this outcome. Significant predictors to poor outcomes included low serum albumin, hyponatremia, the number of malignancy related events, and performance status of 2 or worse on the European cooperative cancer group. We propose a multi-centre review of outcomes to enable evidence-based consultations for patients and their families.
机译:在过去的三十年中,恶性输尿管阻塞(MUO)的管理已经从单一的学科决定演变为多学科方法。必须仔细考虑对个体患者的肾内肾小粒减压的风险和益处。缺乏对意见的共识以及强有力的证据来支持决策过程。在接受治疗的患者中鉴定的结果包括预后,生活质量(QOL),并发症,发病率和预后工具。共有63篇论文。在53篇论文中,中位生存率为这一结果的53篇个月。差的结果的重要预测因子包括低血清白蛋白,低钠血症,恶性相关事件的数量,以及欧洲合作癌癌组的2或更差的性能状况。我们提出了一个多中心审查结果,以便为患者及其家人提供基于证据的咨询。

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