Long-term follow-up results and complications in cancer patients with persistent nephrostomy due to malignant ureteral obstruction

Alma, Ergün; Erçil, Hakan; Vuruşkan, Ediz; Altunkol, Adem; Ünal, Umut; Gürlen, Güçlü; Goren, Vinil; Gürbüz, Zafer Gökhan

doi:10.1007/s00520-020-05662-z

Cited by 10 publications

(15 citation statements)

References 19 publications

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“…[15] In the study of Alma et al, the most commonly isolated agents from PN catheter urine cultures were E coli, Enterococcus spp., and Pseudomonas spp. [16] In this study, ESBL-positive E coli was most commonly isolated from the left PN catheter urine cultures of the patients with recurrent PN catheter-associated urinary tract infections, followed by E faecalis and ESBL-positive K pneumoniae. ESBLpositive K pneumoniae was most commonly isolated from the right PN catheter urine cultures.…”

Section: Discussionmentioning

confidence: 67%

“…[16] The most common infection is pyelonephritis, and long-term PN catheterization has been one of the predisposing factors for infection complications. [16] In this study, the total catheterization time was longer in patients with recurrent PN catheter-related urinary tract infections (P = .000) (Fig. 1).…”

Section: Discussionmentioning

confidence: 99%

“…[ 16 ] The most common infection is pyelonephritis, and long-term PN catheterization has been one of the predisposing factors for infection complications. [ 16 ]…”

Section: Discussionmentioning

confidence: 99%

“…[ 15 ] In another study by Alma et al, previous urological surgery history, diabetes mellitus, and chemotherapy were reported as risk factors for the development of PN catheter-related urinary tract infection in cancer patients. [ 16 ]…”

Section: Discussionmentioning

confidence: 99%

“…In the study of Alma et al, the most commonly isolated agents from PN catheter urine cultures were E coli, Enterococcus spp., and Pseudomonas spp. [ 16 ]…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of risk factors, causative pathogens, and treatment in recurrent percutaneous nephrostomy catheter-related urinary tract infections in cancer patients

et al. 2023

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Introduction: In cancer patients, percutaneous nephrostomy (PN) catheters can be used to relieve obstruction from chemotherapy, radiation therapy, or surgery, thereby improving kidney function and preventing further kidney damage. One of the complications of PN catheters is infections. Recurrent infections may delay chemotherapy, increase antimicrobial resistance with frequent antibiotic use, deteriorate the quality of life of patients, and increase costs. In this study, it was aimed to evaluate risk factors, causative pathogens, and treatment in recurrent PN catheter-related urinary tract infections in cancer patients. Material and method: Cancer patients with PN catheter-associated urinary tract infection who were followed-up in the Infectious Diseases and Clinical Microbiology Clinic between January 1, 2012 and December 31, 2021 were included in the study. Results: The total catheterization time, and occurrence of preinfection catheter replacement, active chemotherapy, and kidney stones were significantly higher in patients with recurrent infection when compared to the other group ( P = .000, P = .000, P = .007, and P = .018, respectively). ESBL-positive Escherichia coli and ESBL-positive Klebsiella pneumoniae were most commonly isolated from the PN catheter urine cultures of patients with recurrent infections. Discussion: Long-term use of the PN catheter increases the risk of urinary tract infection and sepsis. In this study, the total catheterization time, and occurrence of preinfection catheter replacement, active chemotherapy, and kidney stones were found to be risk factors for the development of recurrent PN catheter-related urinary tract infection in cancer patients. Conclusion: It is important to know the risk factors in recurrent PN catheter-related urinary tract infections in cancer patients, take maximum protective measures, and follow-up. Knowing both the causative profile and the resistance rates will increase the chance of success in the treatment when empirical treatment is required. It should also be noted that these patients should be included in the group of patients who need prophylaxis for urinary tract infection.

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Section: Discussionmentioning

confidence: 67%

Section: Discussionmentioning

confidence: 99%

“…[ 16 ] The most common infection is pyelonephritis, and long-term PN catheterization has been one of the predisposing factors for infection complications. [ 16 ]…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…In the study of Alma et al, the most commonly isolated agents from PN catheter urine cultures were E coli, Enterococcus spp., and Pseudomonas spp. [ 16 ]…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of risk factors, causative pathogens, and treatment in recurrent percutaneous nephrostomy catheter-related urinary tract infections in cancer patients

et al. 2023

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Malignant upper urinary tract obstruction in cancer patients: A systematic review

Shah,

Blest,

Blackmur

et al. 2024

BJUI Compass

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ObjectiveTo systematically summarise the current clinical evidence for de novo malignant upper urinary tract obstruction treatment with a focus on standards of reporting, patient outcomes and future research needs.MethodsThis review protocol was published via PROSPERO (CRD42022341588). OVID MEDLINE (R), EMBASE, Cochrane Central Register of Controlled Trials—CENTRAL were searched up to June 2022 in accordance with the Preferred Reporting Items for Systematic Reviews and Meta‐analyses. Prospective and retrospective studies were included.ResultsOf 941 articles identified, 82 with 8796 patients were eligible for inclusion.Most studies in the published literature are retrospective and investigate heterogenous malignancies. Percutaneous nephrostomy and ureteric stenting are the most studied interventions. Few studies describe the outcomes from no intervention or investigate patient perspectives. Overall reported median survival after intervention was around 11.7 months. A lack of standardised reporting of outcomes was evident.ConclusionsMalignant upper urinary tract obstruction is an important clinical condition affecting patients globally. Overall survival after intervention appears poor however the current evidence base has significant limitations due to studies of low methodological quality and the lack of a standardised framework for reporting outcomes.We have provided a pragmatic framework for future studies based on the review to ensure a uniform methodology is utilised moving forward.

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Effect of emergent nephrostomy on long-term total and split renal function in patients with upper urinary tract obstruction due to pelvic malignant tumors

Nishimura,

Takenouchi,

Komatsu

et al. 2024

Pediatr Surg Int

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Purpose This study aimed to investigate the impact of nephrostomies on the outcome of total renal function (TRF) and split renal function (SRF) in patients with malignant pelvic tumors associated with upper urinary tract obstruction (UUTO). Methods Patients with pelvic tumors suffering severe unilateral hydronephrosis treated at our hospital from 2000 to 2022 were included. Data for nephrostomy placement, short- and long-term renal function, and radiological and nuclear imaging studies were collected. The TRF and SRF of patients who underwent nephrostomy were compared to those who did not. Results Seven patients were included (rhabdomyosarcoma: 5, ovarian germ cell tumor: 1, malignant rhabdoid tumor: 1). Nephrostomies were placed in four, which were successfully managed without severe infections. Estimated glomerular filtration rate (eGFR) was significantly improved at the end of treatment in patients with nephrostomy. In contrast, eGFR in patients who did not undergo nephrostomy was not improved. Nuclear imaging studies (renograms or renal scintigrams) revealed impaired SRF of the affected kidney compared to the contralateral kidney, even in patients whose eGFR was within normal levels. Notably, SRF showed a trend to improve over time in one patient treated with nephrostomy. Conclusion Nephrostomy for UUTO caused by pelvic tumors may improve renal outcome.

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Long-term follow-up results and complications in cancer patients with persistent nephrostomy due to malignant ureteral obstruction

Cited by 10 publications

References 19 publications

Evaluation of risk factors, causative pathogens, and treatment in recurrent percutaneous nephrostomy catheter-related urinary tract infections in cancer patients

Evaluation of risk factors, causative pathogens, and treatment in recurrent percutaneous nephrostomy catheter-related urinary tract infections in cancer patients

Malignant upper urinary tract obstruction in cancer patients: A systematic review

Effect of emergent nephrostomy on long-term total and split renal function in patients with upper urinary tract obstruction due to pelvic malignant tumors

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