Abstract
Aim: We aimed to asses the success, complications, ease of application and advantages of percutaneous nephostomy procedure with seldinger tehcnique which can be life saving for most patients with our clinical experience.
Material and Method: 692 patients which we applied percutaneous nephrostomy with Seldinger technique between 2010–2015 are included in this study. Demographic information, etiology of obstruction, success rate and duration of procedure are retrospectively studied.
Results: A total of 692 patients, 394 male and 298 female in the study (M/F: 1.3). Mean age of the patients was 56.6±5.4 years (16–87). 448 (59.49%) of the patients had been applied percutaneous nephrostomy becasue of oncologic obstruction-related hydronephrosis. 6 (0.79%) patients were not treated due to retrorenal colon. 10 (1.32%) patients could not be applied percutaneous nephrostomy. Technical success was 97.87%. The mean procedure time was 8.4 minutes. Mortality were not seen during the procedure. 14 (2.42%) patients were followed up for hematuria and 4 (0.71%) for fever after the procedure.
Conclusion: Ultrasound guided percutaneous nephrostomy procedure is a safe, rapid, effective, and dramatic way to improve the patient’s clinical condition, which causes minimal complications and morbidity in experienced hands. Especially, it is a more advantageous method than Computed Tomography guided percutaneous nephrostomy in terms of cost, not exposed to radiation and practicable in polyclinic. We believe that this practice rescued a serious morbidite such as dialysis in especially patient with obstructive uropathide and eliminated the risk of a possible uremic syndrome is an indispensable part of urology practice and education.
Keywords
References
- 1. Goodwin, W. E., W. C. Casey, and W. Woolf. Percutaneous trocar (needle) nephrostomy in hydronephrosis. J Am Med Assoc 1955 157(11): p.891–4.
- 2. Seldinger, S. I., Catheter replacement of the needle in percutaneous arteriography; a new technique. Acta radiol 1953 39(5): p.368–76.
- 3. Hogan, M. J., B. D. Coley, V. R. Jayanthi, et al. Percutaneous Nephrostomy in Children and Adolescents: Outpatient Management 1. Radiology 2001 218(1): p.207–210.
- 4. Egilmez, H., I. Oztoprak, M. Atalar, 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(7): p.806–813.
- 5. Grabe M, B. -J. T., Botto H, Wullt B, Çek M, Naber KG. Guidelines on urological infections. Eur Ass Urol (EAU), 2011: p.33–39.
- 6. Wah, T., M. Weston, and H. Irving, Percutaneous nephrostomy insertion: outcome data from a propspective multi-operator study at a UK training centre. Clin radiol 2004 59(3): p.255–261.
- 7. Watson, R. A., M. Esposito, F. Richter, et al. Percutaneous nephrostomy as adjunct management in advanced upper urinary tract infection. Urology 1999 54(2): p.234–239.
- 8. Zegel, H., H. Pollack, M. Banner, et al. Percutaneous nephrostomy: comparison of sonographic and fluoroscopic guidance. Am J of Roentgen 1981 137(5): p.925–927.
- 9. Nielsen, O. S. and E. Grossmann. Ultrasonically guided percutaneous nephrostomy. Scand J Urol Nephrol 1990 24(3): p.219–21.
- 10. Sood, G., A. Sood, A. Jindal, et al. Ultrasound guided percutaneous nephrostomy for obstructive uropathy in benign and malignant diseases. Int braz j urol 2006 32(3): p.281–286.
- 11. Kehinde, E., C. Newland, T. Terry, et al. Percutaneous nephrostomies. British journal of urology 1993 71(6): p.664–666.
- 12. Ramchandani, P., J. F. Cardella, C. J. Grassi, et al. Quality improvement guidelines for percutaneous nephrostomy. J Vasc Interv Radiol 2001 12(11): p.1247–51.
- 13. Li, A. C. and S. P. Regalado. Emergent percutaneous nephrostomy for the diagnosis and management of pyonephrosis. in Seminars in interventional radiology 2012. Thieme Medical Publishers.
- 14. Patel, U., Percutaneous nephrostomy insertion: outcome data from a prospective multi-operator study at a UK training centre. Clin Radiol 2004 59(3): p.253–4.
- 15. Farrell, T. A. and M. E. Hicks, A review of radiologically guided percutaneous nephrostomies in 303 patients. J vasc and int radiol 1997 8(5): p.769–774.
- 16. Gupta, S., M. Gulati, K. U. Shankar, et al. Percutaneous nephrostomy with real-time sonographic guidance. Acta Radiol 1997 38(3): p.454–457.
- 17. Sacks, D., T. E. McClenny, J. F. Cardella, et al., Society of Interventional Radiology clinical practice guidelines. J vasc and int radiol 2003 14(9): p. S199-S202.
- 18. Dagli, M. and P. Ramchandani. Percutaneous nephrostomy: technical aspects and indications. in Seminars in interventional radiology 2011. © Thieme Medical Publishers.
Abstract
Amaç: Çalışmamız da, birçok hasta için hayat kurtarıcı olan Seldinger yöntemiyle perkütan nefrostomi uygulamasının başarı, komplikasyon, uygulama kolaylığı ve avantajları açısından klinik verilerimizle birlikte değerlendirmeyi hedefledik.
Materyal ve Metot: 2010–2015 yılları içinde kliniğimizde seldinger tekniği ile peruktan nefrostomi takılan 692 hasta çalışmamıza dahil edildi. Demografik bulguları, obstrüksiyonun etyolojik sebepleri, işlemin başarı oranı, yapılan işlemin uygulama süresi ve komplikasyonları retrospektif olarak incelendi.
Bulgular: Hastaların 394 tanesi erkek 298 tanesi kadın idi (E/K: 1,3). Hastaların yaş ortalaması 56,6±5,4 (16–87) yıl idi. Hastaların 448 (%59,49) tanesine onkolojik nedenli obstruksiyona bağlı hidronefroz (HN) nedeniyle PKN takıldı. 6 (%0,79) hastada retrorenal kolon nedeniyle işlem yapılmadı. 10 (%1,32) hastada PKN takılamadı. Teknik başarı %97,87 idi. İşlem süresi ortalama 8,4 dakika idi. Yapılan işlem esnasında mortalite ile karşılaşılmadı. 14 (%2,42) hasta işlem sonrası hematüri nedeniyle ve 4 (%0,71) hasta ateş nedeniyle kliniğimizde takip edildi.
Sonuç: USG eşliğinde uygulanan PKN işlemi tecrübeli ellerde minimal komplikasyon ve morbiditeye neden olan hızlı, etkili ve hastanın kliniğini dramatik bir şekilde düzelten güvenli bir yöntemdir. Özellikle BT eşliğinde uygulanan yöntemden farklı olarak poliklinik şartlarında uygulanabilmesi, hastanın radyasyona maruz kalmaması ve BT görüntüsü alınmadığından maliyet açısından da daha avantajlı bir yöntemdir. Özellikle obstruktif üropatide hastayı diyaliz gibi ciddi bir morbiditeden kurtaran ve olası üremik sendrom riskini ortadan kaldıran bu uygulamanın üroloji pratiğinin ve eğitiminin vazgeçilmez bir parçası olduğu kanaatindeyiz.
Keywords
References
- 1. Goodwin, W. E., W. C. Casey, and W. Woolf. Percutaneous trocar (needle) nephrostomy in hydronephrosis. J Am Med Assoc 1955 157(11): p.891–4.
- 2. Seldinger, S. I., Catheter replacement of the needle in percutaneous arteriography; a new technique. Acta radiol 1953 39(5): p.368–76.
- 3. Hogan, M. J., B. D. Coley, V. R. Jayanthi, et al. Percutaneous Nephrostomy in Children and Adolescents: Outpatient Management 1. Radiology 2001 218(1): p.207–210.
- 4. Egilmez, H., I. Oztoprak, M. Atalar, 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(7): p.806–813.
- 5. Grabe M, B. -J. T., Botto H, Wullt B, Çek M, Naber KG. Guidelines on urological infections. Eur Ass Urol (EAU), 2011: p.33–39.
- 6. Wah, T., M. Weston, and H. Irving, Percutaneous nephrostomy insertion: outcome data from a propspective multi-operator study at a UK training centre. Clin radiol 2004 59(3): p.255–261.
- 7. Watson, R. A., M. Esposito, F. Richter, et al. Percutaneous nephrostomy as adjunct management in advanced upper urinary tract infection. Urology 1999 54(2): p.234–239.
- 8. Zegel, H., H. Pollack, M. Banner, et al. Percutaneous nephrostomy: comparison of sonographic and fluoroscopic guidance. Am J of Roentgen 1981 137(5): p.925–927.
- 9. Nielsen, O. S. and E. Grossmann. Ultrasonically guided percutaneous nephrostomy. Scand J Urol Nephrol 1990 24(3): p.219–21.
- 10. Sood, G., A. Sood, A. Jindal, et al. Ultrasound guided percutaneous nephrostomy for obstructive uropathy in benign and malignant diseases. Int braz j urol 2006 32(3): p.281–286.
- 11. Kehinde, E., C. Newland, T. Terry, et al. Percutaneous nephrostomies. British journal of urology 1993 71(6): p.664–666.
- 12. Ramchandani, P., J. F. Cardella, C. J. Grassi, et al. Quality improvement guidelines for percutaneous nephrostomy. J Vasc Interv Radiol 2001 12(11): p.1247–51.
- 13. Li, A. C. and S. P. Regalado. Emergent percutaneous nephrostomy for the diagnosis and management of pyonephrosis. in Seminars in interventional radiology 2012. Thieme Medical Publishers.
- 14. Patel, U., Percutaneous nephrostomy insertion: outcome data from a prospective multi-operator study at a UK training centre. Clin Radiol 2004 59(3): p.253–4.
- 15. Farrell, T. A. and M. E. Hicks, A review of radiologically guided percutaneous nephrostomies in 303 patients. J vasc and int radiol 1997 8(5): p.769–774.
- 16. Gupta, S., M. Gulati, K. U. Shankar, et al. Percutaneous nephrostomy with real-time sonographic guidance. Acta Radiol 1997 38(3): p.454–457.
- 17. Sacks, D., T. E. McClenny, J. F. Cardella, et al., Society of Interventional Radiology clinical practice guidelines. J vasc and int radiol 2003 14(9): p. S199-S202.
- 18. Dagli, M. and P. Ramchandani. Percutaneous nephrostomy: technical aspects and indications. in Seminars in interventional radiology 2011. © Thieme Medical Publishers.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Clinical Sciences |
| Journal Section | Research Article |
| Authors | |
| Publication Date | April 1, 2018 |
| Published in Issue | Year 2018 Yıl: 2018 Sayı: 1 |