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 108
- Downloads 0
Microscopic Features of Vaculosynctial Membrane and Synctial Knot Formation in Pregnancy Induced Hypertensive and Normotensive Pregnancies
ABSTRACT Introduction: The placenta accomplishes the functions through its unique anatomical association with mother. Placenta links the mother and fetus by interaction with maternal blood via uteroplacental vessels. Att...
Infratentorial Magnetic Resonance Imaging Evaluation of Joubert Syndrome
Introduction: Joubert syndrome is rare autosomal recessive/X-linked disorder involving the posterior fossa structures. It is often missed clinically and radiologically. However, vermian hypoplasia and ‘molar tooth’ sign...
Imaging Findings with 3D CT Angiographic Reconstruction of Carotico-cavernous Fistula-A Case Report
Carotico Cavernous Fistula (CCF) is an abnormal communication between the carotid arteries and the cavernous sinus. They are divided into direct or indirect types based on the etiology. Direct CCFs present with acute and...
A Morphometric Study of Head of Radius and its Clinical Implication in Radial Head Prosthesis
ABSTRACT Introduction: The head of radius is a fundamental element for the physiological or prosthetic stability of the elbow and superior radio ulnar joint and participates with the fovea radialis in elbow flexion and w...
Magnetic Resonance Imaging of non-Traumatic Pathologies of Ankle and Foot
ABSTRACT Introduction: In patients with ankle and foot pain, especially in non-traumatic cases, MRI plays major role in identifying the etiology. MRI gives more information in the region of ankle and foot because of its...