Percutaneous nephrostomy experience in pediatric patients: comparison of fine and thick needle techniques

Abstract

Objectives: The aim of this study is to assess the effect of needle size in pediatric percutaneous nephrostomy (PN) placement in terms of complications and success rates.

Methods: Seventy one percutaneous nephrostomies were performed in 51 patients aged 1 month to 18 years (mean 6.03 ± 5.88 years) between May 2012 and March 2020. Demographic data, indication for PN placement, puncture technique (calyceal entry level: upper, middle, lower pole or pelvis) and needle size, anesthesia type (general or local anesthesia), duration of catheter use and complications were retrospectively retrieved from the hospital electronic recording system.

Results: Thirty procedures were performed using a 21 gauge needle and 41 procedures using a 18 gauge needle. There was no statistically significant difference between the two groups in terms of age, gender, degree of hydronephrosis, and calyceal entry level. Technical success and complication rates were similar in two groups (p = 0.423).

Conclusions: In the pediatric age group, both 18 and 21 gauge needle techniques can be used safely based on the preference of the interventionalist.

Keywords

• Pediatric patient
• percutaneous nephrostomy
• 18 gauge needle
• 21 gauge needle

References

1. 1. Goodwin WE, Casey WC, Woolf W. Percutaneous trocar (needle) nephrostomy in hydronephrosis. J Am Med Assoc 1955;157:891-4.
2. 2. Winfield AC, Kirchner SG, Brun ME, Mazer MJ, Braren HV, Kirchner FK Jr. Percutaneous nephrostomy in neonates, infants, and children. Radiology 1984;151:617-9.
3. 3. Stanley P, Bear JW, Reid BS. Percutaneous nephrostomy in infants and children. Am J Roentgenol 1983;141:473-7.
4. 4. Irving HC, Arthur RJ, Thomas DFM. Percutaneous nephrostomy in paediatrics. Clin Radiol 1987;38:245-8.
5. 5. Koral K, Saker MC, Morello FP, Rigsby CK, Donaldson JS. Conventional versus modified technique for percutaneous nephrostomy in newborns and young infants. J Vasc Interv Radiol 2003;14:113-6.
6. 6. Ramchandani P, Cardella JF, Grassi CJ, Roberts AC, Sacks D, Schwartzberg MS, et al. Quality improvement guidelines for percutaneous nephrostomy. J Vasc Interv Radiol 2001;12:1247-51.
7. 7. Barnacle AM, Wilkinson AG, Roebuck DJ. Paediatric interventional uroradiology. Cardiovasc Interv Radiol 2011;34:227-40.
8. 8. Nguyen HT, Herndon CA, Cooper C, Gatti J, Kirsch A, Kokorowski P, et al. The Society for Fetal Urology consensus statement on the evaluation and management of antenatal hydronephrosis. J Pediatr Urol 2010;6:212-31.

9. 9. Dagli M, Ramchandani P. Percutaneous nephrostomy: technical aspects and indications. Semin Interv Radiol 2011;28:424-37.
10. 10. Hogan MJ, Coley BD, Jayanthi VR, Shiels WE, Koff SA. Percutaneous nephrostomy in children and adolescents: outpatient management. Radiology 2001;218:207-10.
11. 11. Yavascan O, Aksu N, Erdogan H, Aydin Y, Kara OD, Kangin M, et al. Percutaneous nephrostomy in children: diagnostic and therapeutic importance. Pediatr Nephrol 2005;20:768-72.
12. 12. Sancaktutar AA, Bozkurt Y, Tüfek A, Söylemez H, Önder H, Atar M, et al. Radiation-free percutaneous nephrostomy performed on neonates, infants, and preschool-age children. J Pediatr Urol 2013;9:464-71.
13. 13. Ball WS Jr, Towbin R, Strife JL, Spencer R. Interventional genitourinary radiology in children: a review of 61 procedures. Am J Roentgenol 1986;147:791-6.
14. 14. Shellikeri S, Daulton R, Sertic M, Connolly B, Hogan M, Marshalleck F, et al. Pediatric percutaneous nephrostomy: a multicenter experience. J Vasc Interv Radiol 2018;29:328-34.