Published online Jul 6, 2020. doi: 10.12998/wjcc.v8.i13.2841
Peer-review started: December 23, 2019
First decision: March 5, 2020
Revised: May 12, 2020
Accepted: June 7, 2020
Article in press: June 7, 2020
Published online: July 6, 2020
Processing time: 196 Days and 19.6 Hours
Retroperitoneal fibrosis is an exceptionally rare disease characterized by proliferation of fibrous tissue and inflammation in the retroperitoneum. It features many symptoms in the kidneys and in other organs and usually leads to ureteral obstruction.
Here we present 9 consecutive cases of idiopathic retroperitoneal fibrosis (IRPF) in patients who presented to the Department of Nephrology or Department of Rheumatology, Xuanwu Hospital, Capital Medical University, Beijing, China, between January 2012 and June 2017 with ureteral obstruction due to external compression of the ureter that led to hydronephrosis and kidney dysfunction. Computed tomography imaging was used to identify hydronephrosis and ureteral obstruction and to evaluate kidney function. Each patient was diagnosed with IRPF based on clinical observation and computed tomography examination results. To restore kidney function, a retrograde metallic stent was placed in the ureter under X-ray guidance 2 d after each patient’s admission. No perioperative complications occurred in any patient, but postoperative complications occurred in two patients as follows: Patient 2 had stent migration and repeated metallic stent infections that resolved with treatment; and patient 4 had postoperative hematuria because he resumed normal activities too soon after stent placement (contrary to instruction). Placement of the metallic ureteral stents provided relief from ureteral obstruction and restored kidney function in all patients.
Our 9-case series underscores the utility and efficacy of applying the Resonance® metallic ureteral stent to treat ureteral obstruction in patients with IRPF. For all retroperitoneal fibrosis cases in our series, ureteral stents provided effective relief and were shown to reduce the incidence rate of perioperative and postoperative complications.
Core tip: Nine patients with idiopathic retroperitoneal fibrosis admitted to our institution within a 5-year period received Resonance® metallic stents to restore kidney function. Ureteral obstruction was relieved in all 9 cases, and only 2 patients experienced adverse effects (stent migration and repeated metallic stent infection in one patient and postoperative hematuria in another). Overall, these stents demonstrated effective relief and resulted in fewer complications in the treatment of ureteral stenosis in patients with idiopathic retroperitoneal fibrosis.