[Clinical application of subcutaneous nephrovesical bypass system].

OBJECTIVE: To evaluated the subcutaneous nephrovesical bypass carried out in patients with ureter obstruction and improve the quality of life of patients with palliative definitive percutaneous nephrostomy.
METHODS: A total of 36 patients with advanced cancer receiving 45 subcutaneous nephrovesical bypass tubes were included in the study. Uronephrosis ranged from 1.8-5.2 cm, serum creatinine 73-760 micromol/L,and glomerular filtration rate (GFR) 19-26 mL/min. The obstruction was proved to be complete by retrograde pyelography. The nephrovesical stents were inserted utilizing percutaneous access to both of the kidney and bladder,and a subcutaneous tunnel was created between the two sites. B-ultrasound, KUB (kidneys, ureters, and bladder), serum creatinine test and GFR were carried out 72 hours after operation.
RESULTS: Urinary diversion operations were successful in the 36 patients, uronephrosis ranged from 0-1.8 cm, all stents were in position, serum creatinine 72-173 micromol/L, GFR 25-40 mL/min after the operation, and the bypass functioned well in 45 stents for 67 to 481 days of the follow-up.
CONCLUSION: Subcutaneous nephrovesical bypass can protect renal function of patients suffering from ureteral obstruction by simple and minimum invasive operation; it can also reduce complications caused by percutaneous nephrostomy and improve the patient's life quality.