잠시만 기다려 주세요. 로딩중입니다.

Is emergency percutaneous antegrade drainage of the upper urinary tract useful for future percutaneous nephrolithotomy access?

Investigative and Clinical Urology 2019년 60권 1호 p.29 ~ 34
 ( Sabler Itay M. ) - Hadassah Hebrew University Medical Center Department of Urology

 ( Katafigiotis Ioannis ) - Hadassah Hebrew University Medical Center Department of Urology
 ( Sfoungaristos Stavros ) - Hadassah Hebrew University Medical Center Department of Urology
 ( Lorber Amitay ) - Hadassah Hebrew University Medical Center Department of Urology
 ( Leotsakos Ioannis ) - Hadassah Hebrew University Medical Center Department of Urology
 ( Yutkin Vladimir ) - Hadassah Hebrew University Medical Center Department of Urology
 ( Hidas Guy ) - Hadassah Hebrew University Medical Center Department of Urology
 ( Gofrit Ofer N. ) - Hadassah Hebrew University Medical Center Department of Urology
 ( Duvdevani Mordechai ) - Hadassah Hebrew University Medical Center Department of Urology

Abstract


Purpose: To compare percutaneous nephrolithotomy (PCNL) operations between patients with a preoperative nephrostomy tube and patients that the renal access was obtained at the time of the surgery.

Materials and Methods: We retrospectively evaluated PCNL cases. Patients were divided into two groups. Group 1 ? a non-nephrostomy tube (percutaneous nephrostomy, PCN) group and Group 2 ? patients with a PCN placed before the procedure. All preoperatively placed PCN's were performed in emergency situations by interventional radiologists (IR). Complications were classified according to the Clavien-Dindo classification. We compared stone characteristics, operation time, complications, efficacy and PCN usability at surgery.

Results: Five hundred twenty-seven patients who were submitted to PCNL for renal stones were included in the study. In 73 patients (13.9%) the PCNs were placed before the surgery. Patients and stone characteristics, mean operative time (p=0.830), complications (p=0.859) and stone-free rates (93.0%) were similar between the groups. There was a trend toward higher complication rates in Group 1, but the difference was not statistically significant. Only 21 (29.0%) of preoperatively placed PCNs were used during PCNL for establishing a tract. The reasons for not using PCN tract were: pelvic or infundibular insertion (30.0%) and suboptimal anatomic location (70.0%).

Conclusions: Preoperative emergency inserted PCNs by IR usage rates were low during PCNL. Its placement neither affects the incidence of complications nor affects the operation time and outcomes. As such, when emergency renal drainage is indicated, the need for a future definitive PCNL should not influence the decision about the modality of renal drainage.

키워드

Nephrostomy; Percutaneous nephrolithotomy; Renal lithiasis; Urolithiasis
원문 및 링크아웃 정보
 
등재저널 정보