Ultrasound-Guided Percutaneous Nephrostomy: How to Select Technique?
Journal Title: International Journal of Anatomy Radiology and Surgery - Year 2016, Vol 5, Issue 2
Abstract
ABSTRACT Introduction: Ultrasound guided percutaneous nephrostomy (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), ultrasound-guided puncture needle was inserted into the calyx; a drainage catheter was placed following the guidewire. In one-step 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 one-step 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: Ultrasound-guided 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 one-step technique when hydronephrosis is <3cm. One-step 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.
Authors and Affiliations
Huan Wang, Chuang Cao, Chang-hui Wang, Xing-qiu Fan, Jiang-ya Zhong
Keywords
Related Articles
- EP ID EP472934
- DOI -
- Views 125
- Downloads 0
Diagnostic Performance of the Modern Imaging Modalities in Renovascular Disease: An Evaluation
ABSTRACT Introduction: Renal artery stenosis is a very important cause of Renovascular disease. Atherosclerosis has been identified as a most common etiology for renal artery stenosis. Long standing renal artery stenosis...
Interns, Postgraduate Residents and Non Radiologist Doctors Awareness about Ionizing Radiation in Diagnostic Imaging Investigations in a Tertiary Hospital, Bengaluru
Introduction: Radiological investigations that use ionizing radiations are known to pose health risks to patients subjected to them. Hence, exposure of patients to ionizing radiation during radiological investigations mu...
Spontaneous Bladder Rupture with Delayed Diagnosis - A Challenge to Manage
ABSTRACT Spontaneous bladder rupture is defined as any rupture of urinary bladder in absence of external stimulus. It is a relatively rare phenomenon, with few cases reported in literature. Patients usually present with...
Antenatal Ultrasound Fetal Pinna Measurement and Evolving Nomogram in South Indian Population in Normal Pregnancies
ABSTRACT Introduction: The abnormality of pinna length and morphology can indicate chromosomal anomaly and can be a marker for chromosomal aneuploidy. There are many studies about sonographic pinna length measurements co...
An Unusual Case of Calcific Tendonitis of Flexor Carpi Ulnaris Tendon
Images In Medicine