Ultrasound guided percutaneous nephrostomy for obstructive uropathy in benign and malignant diseases

Sood, Gitanjli; Sood, Ashwani; Jindal, Aditi; Verma, Devendra Kumar; Dhiman, D S

doi:10.1590/s1677-55382006000300004

Cited by 35 publications

(39 citation statements)

References 17 publications

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“…However, peri-organ injury is higher (2.9% Vs. 1.5%) with fluoroscopy and as sonography allows real time imaging it is much safer. [8] Combined use of both the modalities is expected to achieve still better results in terms of success rate and decrease in the occurrence of major complications in PCN [9].…”

Section: Introductionmentioning

confidence: 99%

Success, Effectiveness and Safety of Combined Sonographic and Fluoroscopic Guided Percutaneous Nephrostomy in Malignant Ureteral Obstruction

Bhatt

Verma

Grover

et al. 2017

IJRRT

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Introduction: Percutaneous nephrostomy (PCN) is a palliative procedure required to drain malignant ureteral obstruction to provide reasonable benefit to the patient. The study was conducted with the objective to assess the success, effectiveness and safety of combined USG and Fluoroscopy guided percutaneous nephrostomy in malignant ureteral obstruction.Method: 69 obstructed ureters due to malignant cause in 50 patients were drained by PCN using combined ultrasound (USG) and fluoroscopic guidance. Postprocedural renal function tests were compared to pre-procedural values using paired t-test. Percentage of correct placement of tube and complications were studied.Result: PCN was successful in 98.55% units. Significant improvement in renal function occurred in 88% patients. Mean urea dropped from 89.68mg/dl ±39.95 to 65.34±16.55 mg/d and mean S. creatinine decreased from 4.31±2.84 to 2.61±1.21 between 14-35 days. No statistically significant increase was seen in renal parenchymal thickness. Major complications developed in 4.33% while minor in 50.72% PCN's with pain being the most common complication in 17.39% cases. Conclusion:PCN was successfully performed under combined image guidance and it effectively drained the obstructed kidney. It is a safe procedure but has a high minor complication rate leading to patient morbidity.

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Section: Introductionmentioning

confidence: 99%

Success, Effectiveness and Safety of Combined Sonographic and Fluoroscopic Guided Percutaneous Nephrostomy in Malignant Ureteral Obstruction

Bhatt

Verma

Grover

et al. 2017

IJRRT

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“…The classic method involves imaging guided puncture, guide wire insertion, serial dilatation and tube placement [17]. The success rate ranged from 84%~100% [5,18]. In the present study, we achieved a 100% success rate by using this approach.…”

Section: Resultsmentioning

confidence: 48%

Ultrasound-Guided Percutaneous Nephrostomy: How to Select Technique?

Wang¹

2016

IJARS

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Introduction: Ultrasound guided percutaneous nephro stomy (PCN) is a safe and effective treatment option for obstructive uropathy. Several techniques have been described in documents. However, the recommendation of PCN technique has not been proposed. Aim:To determine the success and complication rates of ultrasound guided PCN. Meanwhile, we attempt to determine a baseline value in order to orient surgeon to select an optimal technique preoperatively. Materials and Methods:This was a retrospective study conducted at Department of Urology of the First People's Hospital of Yueyang City, China. Total 150 PCNs under ultrasound guidance were analyzed. Two puncture techniques were used. In Seldinger technique (ST), ultrasoundguided puncture needle was inserted into the calyx; a drainage catheter was placed following the guide wire. In onestep technique (OT), the drainage catheter set was inserted directly into the collecting system under ultrasound guidance.Statistical Analysis: A statistical analysis was performed using the SPSS software package (versions 19.0). Results:Total 53 PCNs were performed using Seldinger technique, and 97 PCNs were performed using onestep technique. The ST group had higher technical success rate (100% vs 87.6%, p =0.008). The ST group also obtained higher success rate in <3 cm hydronephrosis subgroup (100% vs 44.4%, p<0.05). The success rate in ≥3cm subgroup was similar (100% vs 97.5%). The overall complication rate was 15.1% in ST group and 43.3% in OT group (p<0.05). The major complication rate was 1.9% vs. 13.4% (p<0.05). The minor complication rate was 13.3% vs 29.9% (p<0.05). Conclusion:Ultrasoundguided PCN is an effective and safe treatment method for obstructive uropathy. The Seldinger technique can effectively achieve success in all possible situations and is superior to the onestep technique when hydronephrosis is <3cm. Onestep PCN is an effective and safe procedure in selected patients with hydronephrosis ≥3cm. We recommend 3cm of hydronephrosis should be an acceptable baseline for technique selection.

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“…Advanced malignant neoplasms have been the main indication for PCN, corresponding in different studies to 61, 19 52 20 and 58%. 21 Analysis of the medical history revealed that high blood pressure (HBP) was the most frequent associated disease in both groups (38% in SG and 21% in DG), differing from the findings of the Ministry of Health, which describes 14% HBP in the general population. 22 Perhaps the impairment of renal function that remained chronic in the groups can be related to an increase in the frequency of HBP.…”

Section: Discussionmentioning

confidence: 80%

Cervical cancer: Renal complications and survival after percutaneous nephrostomy

Souza

Kirsztajn

et al. 2016

Rev. Assoc. Med. Bras.

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Introduction:Obstructive nephropathy is a frequent complication in the course of advanced cervical cancer (CC), and ultrasonography-guided percutaneous nephrostomy (PCN) is a well established technique for fast ureteral desobstruction. Objective: To identify possible factors related to the survival and quality of life of patients with advanced CC presenting acute urinary obstructive complications that after desobstruction by PCN recovered urinary flux and renal function. Method: This is an analytical, descriptive, cross-sectional study that included 45 patients with CC who underwent PCN and were divided into 2 groups: "death" (DG) and "survival" (SG), in a public hospital that is reference for oncologic diseases in Northern Brazil. Results: The mean serum creatinine of the patients preceding PCN was >10 mg/ dL, and after PCN <2 mg/dL. The cutoffs of 8.7 g/dL for Hb (p=0.0241) and 27% for Ht (p=0.0065) indicated the values that better discriminate the outcomes of the groups. The presence of low blood pressure was statistically correlated (p=0.0037) to the outcome "death". Changes in glomerular filtration rate (already reduced in all cases) were not associated to the levels of Hb/Ht or to the outcome "death" during the nephrological follow-up. Conclusion: PCN was responsible for the recovery of renal function in 61.7% of the patients, leading to interruption of renal replacement therapy (RRT) in all of those patients. Hb levels >8.7g/dL and Ht >27% were associated to longer survival, and the presence of low blood pressure during follow-up was associated with progression to death.

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Ultrasound guided percutaneous nephrostomy for obstructive uropathy in benign and malignant diseases

Cited by 35 publications

References 17 publications

Success, Effectiveness and Safety of Combined Sonographic and Fluoroscopic Guided Percutaneous Nephrostomy in Malignant Ureteral Obstruction

Success, Effectiveness and Safety of Combined Sonographic and Fluoroscopic Guided Percutaneous Nephrostomy in Malignant Ureteral Obstruction

Ultrasound-Guided Percutaneous Nephrostomy: How to Select Technique?

Cervical cancer: Renal complications and survival after percutaneous nephrostomy

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