Endo-urologically deployed extra-anatomical stents (EAS) - Experience in a tertiary referral center
Author(s):
Dr Sanad Saad
,
Dr Sanad Saad
Affiliations:
Mr Sashi Kommu
,
Mr Sashi Kommu
Affiliations:
Mr Graham Watson
,
Mr Graham Watson
Affiliations:
Mr Simon Mackie
Mr Simon Mackie
Affiliations:
BAUS ePoster online library. Saad S. 06/26/17; 177353; P2-7 Disclosure(s): Nothing to disclose
Dr. Sanad Saad
Dr. Sanad Saad
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Abstract
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Introduction:
An extra-anatomic stent is a stent which holds open a tunnel other than the ureter and which extends further than a standard nephrostomy. There is a paucity in literature of the utility and experience of Extra-anatomical stents (EAS). Herein, we aim to share our experience with the stents in a tertiary referral center in Eastbourne.

Methods:
The EAS we used are specifically Detour stents (Coloplast) composed of a silicone core (20Ch) covered by Polytetrafluoroethylene (PTFE). The external diameter is 28Fr. The study included all patients who had EAS inserted from the period of January 2010 to January 2015. Data was generated via a prospective database. Parameters from the database included patient demographics, indications and complications. The data was then analysed.

Results:
A total of 57 stents were placed in 35 patients. Out of these, 9 were nephro-vesical, 19 were nephro-cutaneous and 7 from kidney to ileal conduit. The indications were bladder cancer, prostate cancer, retroperitoneal fibrosis, bowel cancer obstructing ureters, advanced gynaecological malignancy and benign stricture of the ureter. Nine patients who received 13 stents to bladder, there was 1 stent encrustation, 1 fistulation and 7 died of their malignant disease with stents intact. Longest surviving stent has been in place for 36 months. Seven patients with 8 stents had stenting to ileal conduit. All patients are alive. All of the stents have been removed but after a mean of 20.5 months due to infection and erosion.

Conclusions:
EAS offer patients an acceptable and tolerable alternative to permanent nephrostomies.
Introduction:
An extra-anatomic stent is a stent which holds open a tunnel other than the ureter and which extends further than a standard nephrostomy. There is a paucity in literature of the utility and experience of Extra-anatomical stents (EAS). Herein, we aim to share our experience with the stents in a tertiary referral center in Eastbourne.

Methods:
The EAS we used are specifically Detour stents (Coloplast) composed of a silicone core (20Ch) covered by Polytetrafluoroethylene (PTFE). The external diameter is 28Fr. The study included all patients who had EAS inserted from the period of January 2010 to January 2015. Data was generated via a prospective database. Parameters from the database included patient demographics, indications and complications. The data was then analysed.

Results:
A total of 57 stents were placed in 35 patients. Out of these, 9 were nephro-vesical, 19 were nephro-cutaneous and 7 from kidney to ileal conduit. The indications were bladder cancer, prostate cancer, retroperitoneal fibrosis, bowel cancer obstructing ureters, advanced gynaecological malignancy and benign stricture of the ureter. Nine patients who received 13 stents to bladder, there was 1 stent encrustation, 1 fistulation and 7 died of their malignant disease with stents intact. Longest surviving stent has been in place for 36 months. Seven patients with 8 stents had stenting to ileal conduit. All patients are alive. All of the stents have been removed but after a mean of 20.5 months due to infection and erosion.

Conclusions:
EAS offer patients an acceptable and tolerable alternative to permanent nephrostomies.
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