Percutaneous nephrostomy for stone removal.

Abstract

Percutaneous nephrostomy placement was performed in 700 patients as the initial procedure in renal or ureteral calculus removal. The ease or complexity of the subsequent calculus removal procedure is directly dependent on precise nephrostomy placement. The most important technical factors in nephrostomy placement for calculus removal are selection of the nephrostomy track course, the track entry site into the renal collecting systems, intrarenal catheter and guidewire manipulations, and the final catheter positioning across the ureteropelvic junction and down the ureter.

Percutaneous Nephrostomy with Extensions of the Technique: Step by Step

“…A large-diameter track may be necessary for percutaneous stone therapy, nephroscopy, or antegrade ureteroscopy (13)(14)(15)(16). For such complex manipulations, a "safety" wire is always placed in a stable position (preferably down the ureter) in addition to the working wire.…”

Sonography Guided Percutaneous Nephrostomy: Success Rates According to the Grade of the Hydronephrosis

“…In only one case the procedure was stopped and this was because of dense fibrotic tissue and pain intolerance of the patient, not caused by US guidance. If we accept this case out of the study group, the success rate of US guidance rises to % 100 in grade 3 hydronephrosis and is in the same range with fluoroscopy guided procedures (14).…”

“…These two attempts are a failure but not caused by US guidance and with these two accepted out of the study group, the real success rate of US guidance rises to % 91 in grade 2 hydronephrosis. But this is still under the % 96-100 reported success rates of fluoroscopy guided procedures (2,14).…”

Modern Surgical Treatments of Urinary Tract Obstruction

“…Ultrasound guidance is helpful in determining the depth and the angle of approach. (Juul et al, 1985& LeRoy et al, 1984. Real time ultrasound is widely used for percutaneous access of a dilated collecting system and is beneficial in infants, pregnant women and patients following renal transplantation.…”