Öz
Objective: We aimed to evaluate the efficacy of the percutaneous nephrostomy (PN) performed by using combined ultrasonography (USG) and fluoroscopy.Methods: Eighty-seven patients who underwent 106 PN procedures performed by using USG and fluoroscopy combination between July 2011 and May 2015 were retrospectively analyzed. The technical success was considered if nephrostomy catheter was placed within renal pelvis and functioned spontaneously. All patients received preprocedural prophylactic antibiotic and preprocedural coagulation parameters and platelet count were tested in all patients routinely. The procedural complications are classified as major, minor and catheter-related. The technical success rates and complication rates of the PN procedure were calculated. Results: PN was performed for benign causes in 47 patients (54%) and for malignant causes in 40 patients (46%). A total of 106 nephrostomies were performed in 101 kidneys (95.1%) with dilated systems and in 5 kidneys (4.9%) with non-dilated systems. The technical success rate of PN was 98.1% (104/106 PN procedures). Major complication was not observed in any patients. Transient hematuria as a minor complication was seen in 11 patients (12.6%). Catheter dislodgement occurred in 11 patients (12.6%).Conclusion: The PN performed by using combined USG and fluoroscopy is effective and reliable procedure in urinary decompression and diversion with high success and low complication rates. J Clin Exp Invest 2015; 6 (2): 170
Anahtar Kelimeler
Percutaneous nephrostomy ultrasonography fluoroscopy complications
Kaynakça
- 1. Goodwin WE, Casey WC,Woolf W. Percutaneous trocar (needle) nephrostomy in hydronephrosis. J Am Med Assoc 1955;157:891–894.
- 2. Wah TM, Weston MJ, Irving HC. Percutaneous nephrostomy insertion: outcome data from a prospective multi-operator study at aUKtraining centre. Clin Radiol 2004;59:255–261.
- 3. Radecka E, Magnusson A. Complications associated with percutaneous nephrostomies. A retrospective study. Acta Radiol 2004;45:184–188.
- 4. Egilmez H, Oztoprak I, Atalar M, et al. The place of computed tomography as a guidance modality in percutaneous nephrostomy: analysis of a 10-year single-center experience. Acta Radiol 2007;48:806–813.
- 5. Hausegger KA, Portugaller HR. Percutaneous nephrostomy and antegrade ureteral stenting: technique–indications–complications. Eur Radiol 2006;16:2016–2030.
- 6. American College of Radiology (ACR) and the Standards of Practice Committee of the Society of Interventional Radiology (SIR). Practice guideline for the performance of percutaneous nephrostomy. www.acr.org/./guidelines/iv/ percutaneous nephrostomy.aspx; 2007 [accessed 2014].
- 7. Montvilas P, Solvig J, Johansen TE. Single-centre review of radiologically guided percutaneous nephrostomy using “mixed” technique: success and complication rates. Eur J Radiol 2011;80:553–558.
- 8. Baysal T, Soylu A, Saraç K, et al. Bilgisayarlı tomografi eşliğinde perkütan nefrostomi. Türk Üroloji Dergisi 2003;29:330–336.
- 9. Farrell TA, Hicks ME. A review of radiologically guided percutaneous nephrostomies in 303 patients. J Vasc Interv Radiol 1997;8:769–774.
- 10. Carrafiello G, Lagana D, Mangini M, et al. Complications of percutaneous nephrostomy in the treatment of malignant ureteral obstructions: single centre review. Radiol Med 2006;111:562–571.
- 11. Montanari E, Serrago M, Esposito N, et al. Ultrasound– fluoroscopy guided access to the intrarenal excretory system. Ann Urol (Paris) 1999;33:168–181.
- 12. Dyer RB, Assimos DG, Regan JD. Update on interventional uroradiology. Urol Clin North Am 1997;24:623–652.
- 13. Papanicolaou N. Renal anatomy relevant to percutaneous interventions. Semin Intervent Radiol 1995;12:163–172.
- 14. Millward SF. Percutaneous nephrostomy: a practical approach. J Vasc Interv Radiol 2000;11:955–964.
- 15. Lewis S, Patel U. Major complications after percutaneous nephrostomy lessons from a department audit. Clin Radiol 2004;59:171–179.
- 16. Cochran ST, Barbaric ZL, Lee JJ, Kashfian P. Percutaneous nephrostomy tube placement: an outpatient procedure? Radiology 1991;179:843–847.
- 17. Agostini S, Dedola GL, Gabbrielli S, Masi A. A new percutaneous nephrostomy technique in the treatment of obstructive uropathy. Radiol Med 2003;105:454–461.
- 18. Kaskarelis IS, Papadaki MG, Malliaraki NE, et al. Complications of percutaneous nephrostomy, percutaneous insertion of ureteral endoprosthesis, and replacement procedures. Cardiovasc Intervent Radiol 2001;24:224–228.
- 19. Lee WJ, Patel U, Patel S, Pillari GP. Emergency percutaneous nephrostomy: results and complications. J Vasc Interv Radiol 1994;5:135–139.
- 20. Gedik A, Kılınç İ, Bayrak AH, et al. Obstrüktif Üropatide Ultrasonografi Kılavuzluğunda Perkütan Nefrostomi. Dicle Med J 2008;35:16–20.
- 21. Chalmers N, Jones K, Drinkwater K, et al. The UK nephrostomy audit. Can a voluntary registry produce robust performance data? Clin Radiol 2008;63:888–894.
- 22. Mahaffey KG, Bolton DM, Stoller ML. Urologist directed percutaneous nephrostomy tube placement. J Urol 1994;152:1973–1976.
- 23. Naidich JB, Rackson ME, Mossey RT, Stein HL. Nondilated obstructive uropathy: percutaneous nephrostomy performed to reverse renal failure. Radiology 1986;160:653– 657.
- 24. Patel U, Hussain FF. Percutaneous nephrostomy of nondilated renal collecting systems with fluoroscopic guidance: technique and results. Radiology 2004;233:226–233.
- 25. Yagci C, Ustuner E, Atman ED, et al. Diuretic agent and normal saline infusion technique for ultrasound-guided percutaneous nephrostomies in nondilated pelvicaliceal systems. Cardiovasc Intervent Radiol 2013;36:492–497.
- 26. Gupta S, Gulati M, Suri S. Ultrasound-guided percutaneous nephrostomy in nondilated pelvicaliceal system. J Clin Ultrasound 1998;26:177–179.
Kombine ultrasonografi ve floroskopi kullanılarak gerçekleştirilen perkütan nefrostominin etkinliği: 87 olgunun retrospektif analizi
Öz
Amaç: Bu çalışmada kombine ultrasonografi (USG) ve floroskopi kullanılarak gerçekleştirilen perkütan nefrostomi (PN) işleminin etkinliğini değerlendirmeyi amaçladık.
Yöntemler: Temmuz 2011 ile Mayıs 2015 tarihleri arasında USG ve floroskopi kombinasyonu ile 106 PN işlemi gerçekleştirilen 87 hasta (48 kadın, 39 erkek; ortalama yaş, 58,2; yaş aralığı, 19 ̶ 91) retrospektif olarak incelendi. İşlem sonrası nefrostomi kateterinin renal pelviste yerleşimi ve spontan idrar drenajı teknik başarı olarak kabul edildi. Tüm hastalar işlemden önce profilaktik antibiyotik aldı ve her hastada pıhtılaşma parametreleri ve trombosit sayısı işlemden önce kontrol edildi. İşleme bağlı komplikasyonlar majör, minör ve katetere bağlı komplikasyonlar olarak sınıflandırıldı. PN işleminin teknik başarı ve komplikasyon oranları hesaplandı.
Bulgular: PN 47 hastada (%54) benign nedenlerle, 40 hastada (%46) malign nedenlerle gerçekleştirildi. PN uygulanan 101 renal sistem (%95,1) dilate iken, 5 renal sistemde (%4,9) dilatasyon yoktu. Yüz altı PN işleminin 104’ünde (%98,1) teknik başarı elde edildi. Hastaların hiçbirinde majör komplikasyon gözlenmedi. On bir hastada (%12,6) geçici hematüri şeklinde minör komplikasyon görüldü. On bir hastada (%12,6) kateter çıkması saptandı.
Sonuç: Üriner sistemin dekompresyonu ve diversiyonunda kombine USG ve floroskopi ile gerçekleştirilen PN uygulaması, yüksek teknik başarı ve düşük komplikasyon oranları ile etkili ve güvenilir bir seçenektir.
Anahtar kelimeler: Perkütan nefrostomi, ultrasonografi, floroskopi, komplikasyonlar
Anahtar Kelimeler
Perkütan nefrostomi ultrasonografi floroskopi komplikasyonlar
Kaynakça
- 1. Goodwin WE, Casey WC,Woolf W. Percutaneous trocar (needle) nephrostomy in hydronephrosis. J Am Med Assoc 1955;157:891–894.
- 2. Wah TM, Weston MJ, Irving HC. Percutaneous nephrostomy insertion: outcome data from a prospective multi-operator study at aUKtraining centre. Clin Radiol 2004;59:255–261.
- 3. Radecka E, Magnusson A. Complications associated with percutaneous nephrostomies. A retrospective study. Acta Radiol 2004;45:184–188.
- 4. Egilmez H, Oztoprak I, Atalar M, et al. The place of computed tomography as a guidance modality in percutaneous nephrostomy: analysis of a 10-year single-center experience. Acta Radiol 2007;48:806–813.
- 5. Hausegger KA, Portugaller HR. Percutaneous nephrostomy and antegrade ureteral stenting: technique–indications–complications. Eur Radiol 2006;16:2016–2030.
- 6. American College of Radiology (ACR) and the Standards of Practice Committee of the Society of Interventional Radiology (SIR). Practice guideline for the performance of percutaneous nephrostomy. www.acr.org/./guidelines/iv/ percutaneous nephrostomy.aspx; 2007 [accessed 2014].
- 7. Montvilas P, Solvig J, Johansen TE. Single-centre review of radiologically guided percutaneous nephrostomy using “mixed” technique: success and complication rates. Eur J Radiol 2011;80:553–558.
- 8. Baysal T, Soylu A, Saraç K, et al. Bilgisayarlı tomografi eşliğinde perkütan nefrostomi. Türk Üroloji Dergisi 2003;29:330–336.
- 9. Farrell TA, Hicks ME. A review of radiologically guided percutaneous nephrostomies in 303 patients. J Vasc Interv Radiol 1997;8:769–774.
- 10. Carrafiello G, Lagana D, Mangini M, et al. Complications of percutaneous nephrostomy in the treatment of malignant ureteral obstructions: single centre review. Radiol Med 2006;111:562–571.
- 11. Montanari E, Serrago M, Esposito N, et al. Ultrasound– fluoroscopy guided access to the intrarenal excretory system. Ann Urol (Paris) 1999;33:168–181.
- 12. Dyer RB, Assimos DG, Regan JD. Update on interventional uroradiology. Urol Clin North Am 1997;24:623–652.
- 13. Papanicolaou N. Renal anatomy relevant to percutaneous interventions. Semin Intervent Radiol 1995;12:163–172.
- 14. Millward SF. Percutaneous nephrostomy: a practical approach. J Vasc Interv Radiol 2000;11:955–964.
- 15. Lewis S, Patel U. Major complications after percutaneous nephrostomy lessons from a department audit. Clin Radiol 2004;59:171–179.
- 16. Cochran ST, Barbaric ZL, Lee JJ, Kashfian P. Percutaneous nephrostomy tube placement: an outpatient procedure? Radiology 1991;179:843–847.
- 17. Agostini S, Dedola GL, Gabbrielli S, Masi A. A new percutaneous nephrostomy technique in the treatment of obstructive uropathy. Radiol Med 2003;105:454–461.
- 18. Kaskarelis IS, Papadaki MG, Malliaraki NE, et al. Complications of percutaneous nephrostomy, percutaneous insertion of ureteral endoprosthesis, and replacement procedures. Cardiovasc Intervent Radiol 2001;24:224–228.
- 19. Lee WJ, Patel U, Patel S, Pillari GP. Emergency percutaneous nephrostomy: results and complications. J Vasc Interv Radiol 1994;5:135–139.
- 20. Gedik A, Kılınç İ, Bayrak AH, et al. Obstrüktif Üropatide Ultrasonografi Kılavuzluğunda Perkütan Nefrostomi. Dicle Med J 2008;35:16–20.
- 21. Chalmers N, Jones K, Drinkwater K, et al. The UK nephrostomy audit. Can a voluntary registry produce robust performance data? Clin Radiol 2008;63:888–894.
- 22. Mahaffey KG, Bolton DM, Stoller ML. Urologist directed percutaneous nephrostomy tube placement. J Urol 1994;152:1973–1976.
- 23. Naidich JB, Rackson ME, Mossey RT, Stein HL. Nondilated obstructive uropathy: percutaneous nephrostomy performed to reverse renal failure. Radiology 1986;160:653– 657.
- 24. Patel U, Hussain FF. Percutaneous nephrostomy of nondilated renal collecting systems with fluoroscopic guidance: technique and results. Radiology 2004;233:226–233.
- 25. Yagci C, Ustuner E, Atman ED, et al. Diuretic agent and normal saline infusion technique for ultrasound-guided percutaneous nephrostomies in nondilated pelvicaliceal systems. Cardiovasc Intervent Radiol 2013;36:492–497.
- 26. Gupta S, Gulati M, Suri S. Ultrasound-guided percutaneous nephrostomy in nondilated pelvicaliceal system. J Clin Ultrasound 1998;26:177–179.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Bölüm | Araştırma Yazısı |
| Yazarlar | |
| Yayımlanma Tarihi | 10 Temmuz 2015 |
| Yayımlandığı Sayı | Yıl 2015 Cilt: 6 Sayı: 2 |