Percutaneous Nephrostomy in the Management of Malignant Ureteric Obstruction

Abstract

A study was made of 16 patients who developed renal failure secondary to ureteric obstruction by tumour. All were managed by percutaneous nephrostomy inserted under local anaesthesia. The results in terms of recovery of renal function, subsequent management and long-term outcome are described.

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

“…Of these, 468 were excluded by title and abstract screening, and a further 189 were excluded after full‐text assessment. Of the studies screened, 82 met the study criteria and were included in this review 4–85 . Figure 1 illustrates the process.…”

Urinary diversion in children with pelvic tumors

“…[4][5][6] In our series, 25% (3 of 12) of the nephrostomies were removed after 7 to 22 days, because prompt tumor shrinkage after chemotherapy was noted. Hence, we propose that a nephrostomy should be placed initially in children requiring urinary diversion owing to a tumor obstructing the upper tracts.…”

“…5,14 Urinary tract obstruction may present with a wide range of symptoms according to whether the obstruction is acute or chronic and whether the obstruction is unilateral or bilateral, complete or incomplete. 1 Most of the children presented with nonspecific complaints such as lethargy, weakness, anorexia, vomiting, vague abdominal pain, and a low-grade fever that may reflect an uremic state or constitutional signs of their malignancy.…”

“…Diverting the urinary tract in adults remains controversial, [3][4][5] whereas in children, the obstructed upper urinary tract usually would be diverted, but the best way to divert the obstructed urinary system in children has not been established.…”

Komplikationen bei perkutaner Nephrostomieeinlage

“…Weitaus häufigste Ursache der Harnstauungsnieren sind obturierende Uretersteine, tumorbedingte Stauungen sind demgegenüber deutlich seltener. Der Eingriff wird in der Regel in Lokalanästhesie, eventuell mit Analgosedierung, durchgeführt (4,9,10,18,19). Nur selten ist eine Intubationsnarkose notwendig, z.…”