Acil Durumda Yerleştirilen Perkütan Nefrostomi Kateteri Gelecekteki Perkütan Nefrolitotomi Operasyonu İçin Güvenli ve Etkili Erişim Sağlar
Öz
Amaç: Acil durumlarda yerleştirilen perkütan nefrostomi (PCN) kateterinin gelecekteki perkütan nefrolitotomi (PNL) operasyonunda kullanılabilirliğinin araştırılması amaçlandı.
Gereç ve Yöntemler: Ocak 2013 ile Aralık 2018 tarihleri arasında PNL ameliyatı öncesinde acil durumlarda girişimsel radyolog tarafından PCN kateteri takılan hastalar çalışmaya dahil edildi. Demografik özellikler, PCN takılma endikasyonu, taş özellikleri, ameliyat öncesi ve sonrası laboratuvar değerleri, ameliyat sırasındaki veriler, PCN kateterinin renal erişim için kullanılabilirliği/kullanılamazlığı, ameliyat sonrası veriler ve komplikasyonlar kaydedildi.
Bulgular: Çalışmaya toplam 32 hasta dahil edildi. (PCN kullanılabilir: 21, kullanılamaz: 11). Kateter takılma endikasyonu 26 (%81,25) hastada obstrüksiyon, 6 (%18,75) hastada ise idrar yolu enfeksiyonuydu. PNL sırasında 21 (%65,62) hastada PCN kateter yolu kullanılarak renal erişim sağlandı. En yaygın PCN erişimi alt kutuptan kullanıldı. On bir (%34,37) hastada PCN traktı erişim için elverişli değildi. Kaliksin giriş için uygun olmaması nedeniyle PCN’nin kullanılamadığı hastalarda en sık yeni erişim yeri 6 hastada alt kaliks, 3 hastada üst kaliks ve 2 hastada orta kaliks oldu. PCN kateterinin PNL erişimi için kullanılabilir olduğu ve kullanılamadığı iki grup arasında ortalama hastanede kalış süresi dışında (p=0.039) istatistiksel olarak anlamlı fark yoktu (p>0,05).
Sonuç: PNL ameliyatı öncesinde yerleştirilen PCN kateterleri, ameliyat sırasında renal erişim amacıyla etkin ve güvenli bir şekilde kullanılabilir. Ancak acil durumlarda, ileride ameliyat olacak hastalarda PCN kateterinin uygun kaliksten yerleştirilmesi önemlidir.
Anahtar Kelimeler
nefrolitotomi perkütan nefrostomi böbrek erişimi girişimsel radyolog taş
Kaynakça
- 1. Patel SR, Nakada SY. The modern history and evolution of percutaneous nephrolithotomy. J Endourol. 2015;29(2):153-7. https://doi.org/10.1089/end.2014.0287
- 2.Tepeler A, Armağan A, Akman T, Polat EC, Ersöz C, Topaktaş R, et al. Impact of percutaneous renal access technique on outcomes of percutaneous nephrolithotomy. J Endourol. 2012;26(7):828-33. https://doi.org/10.1089/end.2011.0563
- 3. Tomaszewski JJ, Ortiz TD, Gayed BA, Smaldone MC, Jackman SV, Averch TD. Renal access by urologist or radiologist during percutaneous nephrolithotomy. J Endourol. 2010;24(11):1733-7. https://doi.org/10.1089/end.2010.0191
- 4. Bearelly P, Lis C, Trussler J, Katz MH, Babayan RK, Wang DS. Nephrostomy tube placement prior to percutaneous nephrolithotomy does not impact outcomes. Can J Urol. 2018;25(5):9497-9502. PMID: 30281007
- 5.Benson AD, Juliano TM, Miller NL. Infectious outcomes of nephrostomy drainage before percutaneous nephrolithotomy compared to concurrent access. J Urol. 2014;192(3):770-4. https://doi.org/10.1016/j.juro.2014.03.004
- 6.Chen SH, Wu WJ, Chou YH, Yeh HC, Tsai CC, Chueh KS, et al. Comparison one-step procedure with two-step procedure in percutaneous nephrolithotomy. Urolithiasis. 2014;42(2):121-6. https://doi.org/10.1007/s00240-013-0616-1
- 7. Cobb KD, Gomella PT, DiBianco JM, Batter TH, Eisner BH, Mufarrij PW. Are Emergently Placed Nephrostomy Tubes Suitable for Subsequent Percutaneous Endoscopic Renal Surgery? Urology. 2019;126:45-48. https://doi.org/10.1016/j.urology.2019.01.006
- 8. Bradshaw AW, Bechis SK, Cobb KD, Friedlander DF, DiPina T, Sur RL. Nephrostomy tubes placed emergently prior to percutaneous renal stone surgery are practical for obtaining access. Arch Esp Urol. 2020;73(9):837-842. English, Spanish. PMID: 33144538
- 9. Sabler IM, Kata'giotis I, Sfoungaristos S, Lorber A, Leotsakos I, Yutkin V, et al. Is emergency percutaneous antegrade drainage of the upper urinary tract useful for future percutaneous nephrolithotomy access? Investig Clin Urol. 2019;60(1):29-34. https://doi.org/10.4111/icu.2019.60.1.29.
- 10. de la Rosette JJ, Opondo D, Daels FP, Giusti G, Serrano A, Kandasami SV, et al; CROES PCNL Study Group. Categorisation of complications and validation of the Clavien score for percutaneous nephrolithotomy. Eur Urol. 2012;62(2):246-55. https://doi.org/10.1016/j.eururo.2012.03.055
- 11. Pearle MS, Pierce HL, Miller GL, Summa JA, Mutz JM, Petty BA, et al. Optimal method of urgent decompression of the collecting system for obstruction and infection due to ureteral calculi. J Urol. 1998;160(4):1260-4. PMID: 9751331
- 12. Yossepowitch O, Lifshitz DA, Dekel Y, Gross M, Keidar DM, Neuman M, et al. Predicting the success of retrograde stenting for managing ureteral obstruction. J Urol. 2001;166(5):1746-9. PMID: 11586215
- 13. Patel AP, Bui D, Pattaras J, Ogan K. Upper pole urologist- obtained percutaneous renal access for PCNL is safe and e(cacious. Can J Urol. 2017;24:8754-8. PMID: 28436364
- 14.Taylor E, Miller J, Chi T, Stoller ML. Complications associated with percutaneous nephrolithotomy. Transl Androl Urol. 2012;1(4):223-8. https://doi.org/10.3978/j.issn.2223-4683.2012.12.01
- 15. Barghouthy Y, Kourmpetis V, Dekalo S, Bar-Yosef Y, Conti S, Greenstein A, et al. A Novel Method for Repositioning Suboptimally Preoperatively Placed Nephrostomy Tubes for Percutaneous Nephrolithotomy Without Renal Repuncture. J Endourol. 2021;35(6):908-911. https://doi.org/10.1089/end.2017.0725
Emergency Placed Percutaneous Nephrostomy Catheter Provides Safe and Effective Access for Future Percutaneous Nephrolithotomy Operation
Öz
Objective: It was aimed to investigate the feasibility of the percutaneous nephrostomy (PCN) catheter placed in an emergency in the future percutaneous nephrolithotomy (PNL) operation.
Material and Methods: Patients who underwent PCN catheter insertion by an interventional radiologist under emergency situations prior to PNL surgery between January 2013 and December 2018 were included in the study. Demographic characteristics, indication for PCN insertion, stone characteristics, pre- and post-operative laboratory values, intra-operative data, usability/non-usability of PCN catheter for renal access, post-operative data and complications were recorded.
Results: A total of 32 patients were included in the study. (PCN usable: 21, unusable: 11). Indications for catheter insertion were obstruction in 26 (81.25%) patients and urinary tract infection in 6 (18.75%) patients. Renal access was achieved in 21 (65.62%) patients by using the PCN catheter tract during PNL. The most common PCN access was used in the inferior pole. In 11 (34.37 %) patients, the PCN tract was not usable for access. In patients in whom PCN was unusable due to an unsuitable calyx for access, the most common new access site was the inferior calyx in 6 patients, the superior calyx in 3 patients and the middle calyx in 2 patients. There was no statistically significant difference between the two groups in which the PCN catheter was usable and unusable for PNL access (p>0.05), except for the mean length of hospital stay (p=0.039).
Conclusions: PCN catheters inserted prior to PNL surgery can be used effectively and safely for renal access during surgery. However, in emergency cases, it is important that the PCN catheter is inserted through the appropriate calyx in patients undergoing future surgery.
Anahtar Kelimeler
nephrolithotomy percutaneous nephrostomy renal access interventional radiology stone
Kaynakça
- 1. Patel SR, Nakada SY. The modern history and evolution of percutaneous nephrolithotomy. J Endourol. 2015;29(2):153-7. https://doi.org/10.1089/end.2014.0287
- 2.Tepeler A, Armağan A, Akman T, Polat EC, Ersöz C, Topaktaş R, et al. Impact of percutaneous renal access technique on outcomes of percutaneous nephrolithotomy. J Endourol. 2012;26(7):828-33. https://doi.org/10.1089/end.2011.0563
- 3. Tomaszewski JJ, Ortiz TD, Gayed BA, Smaldone MC, Jackman SV, Averch TD. Renal access by urologist or radiologist during percutaneous nephrolithotomy. J Endourol. 2010;24(11):1733-7. https://doi.org/10.1089/end.2010.0191
- 4. Bearelly P, Lis C, Trussler J, Katz MH, Babayan RK, Wang DS. Nephrostomy tube placement prior to percutaneous nephrolithotomy does not impact outcomes. Can J Urol. 2018;25(5):9497-9502. PMID: 30281007
- 5.Benson AD, Juliano TM, Miller NL. Infectious outcomes of nephrostomy drainage before percutaneous nephrolithotomy compared to concurrent access. J Urol. 2014;192(3):770-4. https://doi.org/10.1016/j.juro.2014.03.004
- 6.Chen SH, Wu WJ, Chou YH, Yeh HC, Tsai CC, Chueh KS, et al. Comparison one-step procedure with two-step procedure in percutaneous nephrolithotomy. Urolithiasis. 2014;42(2):121-6. https://doi.org/10.1007/s00240-013-0616-1
- 7. Cobb KD, Gomella PT, DiBianco JM, Batter TH, Eisner BH, Mufarrij PW. Are Emergently Placed Nephrostomy Tubes Suitable for Subsequent Percutaneous Endoscopic Renal Surgery? Urology. 2019;126:45-48. https://doi.org/10.1016/j.urology.2019.01.006
- 8. Bradshaw AW, Bechis SK, Cobb KD, Friedlander DF, DiPina T, Sur RL. Nephrostomy tubes placed emergently prior to percutaneous renal stone surgery are practical for obtaining access. Arch Esp Urol. 2020;73(9):837-842. English, Spanish. PMID: 33144538
- 9. Sabler IM, Kata'giotis I, Sfoungaristos S, Lorber A, Leotsakos I, Yutkin V, et al. Is emergency percutaneous antegrade drainage of the upper urinary tract useful for future percutaneous nephrolithotomy access? Investig Clin Urol. 2019;60(1):29-34. https://doi.org/10.4111/icu.2019.60.1.29.
- 10. de la Rosette JJ, Opondo D, Daels FP, Giusti G, Serrano A, Kandasami SV, et al; CROES PCNL Study Group. Categorisation of complications and validation of the Clavien score for percutaneous nephrolithotomy. Eur Urol. 2012;62(2):246-55. https://doi.org/10.1016/j.eururo.2012.03.055
- 11. Pearle MS, Pierce HL, Miller GL, Summa JA, Mutz JM, Petty BA, et al. Optimal method of urgent decompression of the collecting system for obstruction and infection due to ureteral calculi. J Urol. 1998;160(4):1260-4. PMID: 9751331
- 12. Yossepowitch O, Lifshitz DA, Dekel Y, Gross M, Keidar DM, Neuman M, et al. Predicting the success of retrograde stenting for managing ureteral obstruction. J Urol. 2001;166(5):1746-9. PMID: 11586215
- 13. Patel AP, Bui D, Pattaras J, Ogan K. Upper pole urologist- obtained percutaneous renal access for PCNL is safe and e(cacious. Can J Urol. 2017;24:8754-8. PMID: 28436364
- 14.Taylor E, Miller J, Chi T, Stoller ML. Complications associated with percutaneous nephrolithotomy. Transl Androl Urol. 2012;1(4):223-8. https://doi.org/10.3978/j.issn.2223-4683.2012.12.01
- 15. Barghouthy Y, Kourmpetis V, Dekalo S, Bar-Yosef Y, Conti S, Greenstein A, et al. A Novel Method for Repositioning Suboptimally Preoperatively Placed Nephrostomy Tubes for Percutaneous Nephrolithotomy Without Renal Repuncture. J Endourol. 2021;35(6):908-911. https://doi.org/10.1089/end.2017.0725
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Üroloji |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 31 Ocak 2024 |
| Gönderilme Tarihi | 16 Aralık 2023 |
| Kabul Tarihi | 25 Ocak 2024 |
| Yayımlandığı Sayı | Yıl 2024 Cilt: 16 Sayı: 1 |
