Gebelikte Ultrasonografi Kılavuzluğunda Gerçekleştirilen Perkütan Nefrostomi İşlemi Etkin ve Güvenli Midir?: Tek Merkez Deneyimi

Yıl 2023, Sayı: 21, 843 - 853, 05.01.2024

İlhan Nahit Mutlu , Ali Dablan , Mehmet Cingöz , Tuğçe Arslanoğlu , Özgür Kılıçkesmez

https://doi.org/10.38079/igusabder.1366562

Öz

Amaç: Çalışmanın amacı gebelikte uygulanan ultrason eşliğinde perkütan nefrostomi (PN) yerleştirilmesi işleminin etkinlik ve güvenilirliğini ortaya koymaktır.
Yöntem: Haziran 2020 ile Haziran 2023 tarihleri arasında merkezimizde gebe hastalarda uygulanan PN yerleştirilmesi işlemleri retrospektif olarak taranarak işlem parametreleri, görüntüleme bulguları, teknik başarı, işlem komplikasyonları ve gebelik sonuçları değerlendirilmiştir.
Bulgular: PN yerleştirilmesi uygulanan hastalarda ortalama gebelik yaşı 29,04±7,01 hafta olup 7 ile 36 hafta arasında değişmekteydi. PN endikasyonları sırasıyla taş (%46,2), piyelonefrit (%34,6) ve gebeliğe bağlı taşsız semptomatik hidronefroz (%19,2) idi. 27 işlemden 25'inde (%92,59) PN işlemi başarılı şekilde gerçekleştirilmiş olup major komplikasyon saptanmamıştır. Üç vakada geçici hematüri şeklinde minor komplikasyon saptanmıştır. Kataterin ortalama takılı kalma süresi 72,58 gündür. İşlem yapılan tüm hastalarda semptomatik ve klinik iyileşme sağlanmıştır. PN uygulanan 22 gebede (%84,6) zamanında doğum, 3 gebede (%11,5) erken doğum ve 1 gebede (%3,8) düşük saptanmıştır.
Sonuç: Ultrason eşliğinde PN yerleştirilmesi işlemi gebelikte obstrüktif hidronefroz varlığında yüksek başarı oranı ile uygulanabilen etkin ve güvenilir bir yöntemdir. Bu prosedür, iyonlaştırıcı radyasyonun kullanılmasını önleyerek hem fetusun hem de annenin güvenliğini sağlar.

Anahtar Kelimeler

Hidronefroz, nefrostomi, perkütan, gebelik

Is Ultrasound-Guided Percutaneous Nephrostomy Efficacious and Safe in Pregnant Patients?: A Single Center Experience

Öz

Aim: To evaluate the safety and efficacy of ultrasound-guided percutaneous nephrostomy (PCN) placement in pregnancy.
Method: Medical records of 26 pregnant patients who were inserted with a total of 27 PCN catheters between June 2020 to June 2023 were retrospectively analyzed to assess imaging findings, procedural parameters, technical success, delivery outcomes, and procedural complications.
Results: At the time of placement of the PCN, the mean gestational age was 29.04±7.01 weeks (range 7 - 36 weeks). The indications for insertion of the PCN catheter included: 1) obstructing calculi (46.2%), 2) pyelonephritis (34.6%), and 3) symptomatic hydronephrosis without calculi (19.2%). Successful catheter placement was achieved in 25/27 procedures, yielding a success rate of 92.59%, and no major complications. Minor instances of transient hematuria were encountered in three cases. The mean duration of catheter retention was 72.58 days. All patients exhibited significant clinical and symptomatic improvement. Among these patients, 22 patients (84.6%) delivered their babies at full-term, 3 patients (11.5%) delivered prematurely, and 1 patient (3.8%) experienced a miscarriage.
Conclusion: Ultrasound-guided PCN placement is a reliable method with high success and efficacy that can be applied during pregnancy. This procedure avoids the use of ionizing radiation, ensuring safety for both the fetus and the mother.

Anahtar Kelimeler

Hydronephrosis, nephrostomy, percutaneous, pregnancy

Kaynakça

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