Radiologically guided percutaneous nephrostomy: A 6-year single-center experience

Yıl 2019, , 142 - 147, 01.12.2019

Mehmet Şeker , Türkmen Turan Çiftçi , Devrim Akıncı Okan Akhan

https://doi.org/10.25000/acem.605006

Öz

Aim: To retrospectively analyze the
indications, underlying pathologies, technical success rate, complications and
benefit of percutaneous nephrostomies in a single centre.

Materials and Methods: Data of 578 patients
who underwent radiologically guided percutaneous nephrostomy between January 1999 and December 2004 were retrospectively reviewed. The mean age
of the patients was 42.5 years (range, 6 days–90 years). The indications were urinary obstruction without urinary infection
(77.9%),  urinary obstruction with
urinary infection (13.1%), urinary diversion (6.9%) and diagnostic testing
(2.1%).

Results: The technical success rate was
99.4%. There was no procedure related mortality. Major
hemorrhage or sepsis were not observed in children. Major hemorrhage occurred in 1.55% and sepsis occured in 2.65% of adult patients. Catheter dislodgement was the commonest
complication with an overall rate of 11.4%. In 7.2% patients, percutaneous
nephrostomy was successful in managing patients without further intervention.  36.5% of patients had surgery and 14.7%  had ureteral stenting as definitive
treatment. 

Conclusion: Radiologically guided percutaneous
nephrostomy, can be used effectively, and safely in a wide variety of
indications with high technical success and low complications rates.

Anahtar Kelimeler

Percutaneous nephrostomy, urinary system obstruction, urinary leakage, urinary fistula, interventional radiology

Görüntüleme kılavuzluğunda perkütan nefrostomi: 6 yıllık tek merkez deneyimi

Öz

Amaç: Perkütan nefrostomilerin,
endikasyonlarını, altta yatan patolojileri, teknik başarı oranını, komplikasyonları
ve genel faydalarını retrospektif olarak incelemek.

Materyal ve Metod: Ocak 1999 ile Aralık 2004
tarihleri arasında görüntüleme kılavuzluğunda perkütan nefrostomi yapılan 578
hastanın verileri retrospektif olarak incelenmiştir. Hastaların ortalama yaşı
42,5 yıl idi (6 gün–90 yıl).  İşlem
endikasyonları üriner enfeksiyon olmadan obstrüksiyon varlığı (% 77,9), üriner
enfeksiyon ile beraber obstrüksiyon varlığı (%13,1), üriner diversiyon (%6,9)
ve böbrek fonksiyonları değerlendirme (%2,1) idi.

Bulgular: Teknik başarı oranı % 99,4 idi.
İşlemle ilişkili mortalite izlenmedi. Çocuklarda major hemoraji ya da sepsis
görülmemişti. Erişkin hastalarda major kanama oranı % 1,55, sepsis oranı ise %2,65
idi. Kateter dislokasyonu en sık ortaya çıkan komplikasyondu ve oranı toplamda
%11,4 idi. Hastaların %7,2'sinde başka girişim yapılmadan perkütan nefrostomi
ile başarılı tedavi sağlandı. Hastaların %36,5'inde cerrahi ile ve %14,7'sinde
ise üreteral stent yerleştirilerek kesin tedavi sağlandı.

Sonuç: Radyoloji kılavuzluğunda yapılan perkütan
nefrostomi, yüksek teknik başarı ve düşük komplikasyon oranları ile çok çeşitli
endikasyonlarda etkili ve güvenli bir şekilde kullanılabilir.

Anahtar Kelimeler

Perkütan nefrostomi, üriner sistem obstrüksiyonu, üriner sistem kaçağı, üriner fistül, girişimsel radyoloji

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