Factors Affecting Success of the Reinsertion of Nephrostomy Catheters through the Original Tract

Year 2022, Volume: 12 Issue: 2, 328 - 334, 30.06.2022

Mustafa Gök Oghuz Abdullayev Mehmet Burak Çildağ

https://doi.org/10.31832/smj.1118650

Abstract

Objective: To investigate the success rate and the factors affecting the success of percutaneous nephrostomy catheter reinsertion using the existing percutaneous tract.
Materials and methods: Retrospective analysis was performed in 47 adult patients who underwent percutaneous nephrostomy catheter reinsertion through existing tract between December 2020 and December 2021. We reviewed the success rate of the reinsertion, the relationship between that rate, the dislodged catheter size, the indwelling time (time between placement and dislodgement) and the timeline that the original tract can be used for reinsertion procedure.
Results: The overall success rate for reinsertion through existing tract was 70.21%. Success rate of reinsertion was associated with longer catheter indwelling times compared to patients who failed reinsertion (82.27 vs 34.21 days, p < 0.001) and shorter reinsertion times compared to patients who failed reinsertion (13.21 vs 65.86 hours, p < 0.001). Receiver Operating Characteristic (ROC) curve analysis demonstrated that the cut-off time for reinsertion was 33 hours, with 84.80 % sensitivity and 85.70 % specificity.
Conclusions: Reinsertion of the percutaneous nephrostomy catheters using the existing tract has many advantages over the new tract intervention. Reinsertion can be performed successfully after the first 24-36 hours of dislodgement. Success rates vary based on indwelling and reinsertion times.

Keywords

Percutaneous nephrostomy, nephrostomy reinsertion, cutaneous tract

Nefrostomi Kateterlerinin Orijinal Yolak Kullanılarak Yeniden Yerleştirilmesinin Başarısını Etkileyen Faktörler

Abstract

Amaç: Mevcut perkütan yol kullanılarak nefrostomi kateterlerinin yeniden yerleştirilmesindeki başarı oranını ve işlem başarısını etkileyen faktörleri araştırmak.
Gereç ve Yöntemler: Aralık 2020 ile Aralık 2021 arasında mevcut yolak üzerinden yeniden perkütan nefrostomi kateteri yerleştirilen 47 yetişkin hastada retrospektif analiz yapıldı. Kateterin aynı yolak kullanılarak yerine takılma başarı oranı, bu oran ile kateter boyutu, kateterin ilk takılma zamanı ile çıkma arasındaki zaman ve aynı yolağın kullanılabileceği zaman aralığı değerlendirildi.
Bulgular: Mevcut yolak üzerinden yeniden perkütan nefrostomi kateteri yerleştirme işleminde genel başarı oranı %70.21 idi. Yeniden yerleştirme işleminde başarı oranı, işlemin başarısız olduğu hastalara kıyasla önceki kateterin daha uzun kalma süresi (82.27'ye karşı 34.21 gün, p < 0.001) ve yeni kateterin daha kısa zamanda yerleştirilmesi (13.21'e karşı 65.86 saat, p < 0.001) ile ilişkiliydi. İşlem karakteristik (ROC) eğrisi analizinde, yeniden yerleştirme süresi için kesme değeri %84.80 duyarlılık ve %85.70 özgüllük ile 33 saat olduğu bulunmuştur.
Sonuç: Mevcut trakt kullanılarak perkütan nefrostomi kateterlerinin yeniden yerleştirilmesi, yeni trakt müdahalesine göre daha avantajlıdır. Yeniden yerleştirme, kateter çıktıktan sonra ilk 24-36 saatlik süre içerisinde başarıyla gerçekleştirilebilir. Başarı oranları, önceki kateterin kalma süresi ve yeniden yerleştirme sürelerine göre değişir.

Keywords

Perkütan nefrostomi, nefrostominin yeniden takılması, kütanöz yolak

References

• Reference1 Millward SF. Percutaneous nephrostomy: a practical approach. J Vasc Interv Radiol 2000; 11:955–964.
• Referece2 Wah TM, Weston MJ, Irving HC. Percutaneous nephrostomy insertion: outcome data from a prospective multioperator study at a UK training centre. Clin Radiol 2004; 59:255–261.
• Reference3 Ramchandani P, Cardella JF, Grassi CJ, Roberts AC, Sacks D, Schwartzberg MS, et al. Quality improvement guidelines for percutaneous nephrostomy. J Vasc Interv Radiol 2003; 14:S277–281.
• Reference4 Sim LS, Tan BS, Yip SK, Ng CK, Lo RH, Yeong KY et al. Single center review of radiologically-guided percutaneous nephrostomies: a report of 273 procedures. Ann Acad Med Singapore 2002; 31:76–80.
• Reference 5 Egglin TK, Rosenblatt M, Dickey KW, Houston JP, Pollak JS. Replacement of accidentally removed tunneled venous catheters through existing subcutaneous tracts. J Vasc Interv Radiol 1997; 8:197–202.
• Reference 6 Wah TM, Weston MJ, Irving HC. Percutaneous nephrostomy insertion: outcome data from a prospective multioperator study at a UK training centre. Clin Radiol 2004; 59:255–261.
• Reference7 Lewis S, Patel U. Major complications after percutaneous nephrostomy: lessons from a department audit. Clin Radiol 2004; 59:171–179. 13.
• Reference 8 Farrell TA, Hicks ME. A review of radiologically guided percutaneous nephrostomies in 303 patients. J Vasc Interv Radiol 1997; 8:769–774. 14.
• Reference9 Farrell TA, Michael W, Hicks ME. Long-term results of transrenal ureteral occlusion with use of Gianturco coils and gelatin sponge pledgets. J Vasc Interv Radiol 1997; 8:449–452.
• Reference10 Stables DP, Ginsberg NJ, Johnson ML. Percutaneous nephrostomy: a series and review of the literature. AJR Am J Roentgenol 1978; 130:75–82.
• Reference11 Saad WEA. Inadvertent discontinuation of percutaneous nephrostomy catheters in adult native kidneys: incidence and percutaneous management. J Vasc Interv Radiol 2006; 17:1457– 1464.
• Reference12 Fiuk J, Bao Y, Calleary JG, Schwartz BF, Denstedt JD. The use of internal stents in chronic ureteral obstruction. J Urol 2015; 193:1092.
• Reference13 Sountoulides P, Pardalidis N, Sofikitis N. Endourologic management of malignant ureteral obstruction: indications, results, and quality-of-life issues. J Endourol 2010; 24:129.
• Reference14 Borofsky MS, Walter D, Shah O, Goldfarb DS, Mues AC, Makarov DV. Surgical decompression is associated with decreased mortality in patients with sepsis and ureteral calculi. J Urol 2013; 189:946.
• Reference15 Izumi K, Mizokami A, Maeda Y, Koh E, Namiki M. Current outcome of patients with ureteral stents for the management of malignant ureteral obstruction. J Urol 2011; 185:556.
• Reference16 Pearle MS, Pierce HL, Miller GL, Summa JA, Mutz JM, Petty BA, et al. Optimal method of urgent decompression of the collecting system for obstruction and infection due to ureteral calculi. J Urol 1998; 160:1260.
• Reference17 Ramsey S, Robertson A, Ablett MJ, Meddings RN, Hollins GW, Little B. Evidence-based drainage of infected hydronephrosis secondary to ureteric calculi. J Endourol 2010; 24:185.
• Reference18 Philip John Haslam, Percutaneous Renal Drainage Procedures, In Matthew A. Mauro, Kieran P. Murphy, Kenneth R. Thomson(eds) Expert Radiology,Image-Guided Interventions. 3rd ed. Elsevier, 2020. p811-822.e2
• Reference19 Radeka E, Magnusson A. Complications associated with percutaneous nephrostomies: a retrospective study. Acta Radiol 2004; 45:184–188.
• Reference20 Gordon R, Oleaga J, Ring R, Freiman D, Funaro A. Replacing the “fallen out” catheter. Radiology 1980; 134:537.
• Reference21 Pollack H, Banner M. Replacing blocked or dislodged percutaneous nephrostomy and ureteral stent catheters. Radiology 1982; 145:203–205.
• Reference22 Collares FB, Faintuch S, Kim SK, Rabkin DJ. Reinsertion of accidentally dislodged catheters through the original track: what is the likelihood of success?. Journal of Vascular and Interventional Radiology. 2010 Jun 1;21(6):861-4.