Editorial comment on: Ureteral obstruction: is the full metallic double-pigtail stent the way to go?

摘要

Malignant extrinsic or benign intrinsic strictures can be managed byJJ stenting. Nevertheless, the rate of failure is high in patients with extrinsic obstruction, and conventional JJ stents are associated with recurrent obstruction and encrustation requiring 3-6 monthly changes [1]. Liatsikos and colleagues assessed a new metallic JJ stent (Resonance.) that displays high compressive and tensile strength, making it theoretically recommended for 1-yr duration [2,3]. They demonstrated in a large series of patients that malignant ureteric obstructions were relieved in 100% of patients [2]. The results were less adequate in patients with benign obstruction and clearly were unsatisfactory in patients with obstructed metal mesh stents. Consequently, the authors concluded that careful selection of patients is mandatory, since metallic JJ stents are intended for patients with malignant strictures. In such patients, the mean obstruction relief duration was 11 mo [2], which is significantly better than the results obtained with plastic JJ stents [1].