Evaluation of Hydronephrosis With Tubeless Cutaneous Ureterostomy Using Tc-99m MAG3 Diuretic Renography

Kim, Chul Jang; Takimoto, Keita; Tomita, Kengo; Osafune, Takashi; Nishikawa, Nobuyuki; Johnin, Kazuyoshi; Okada, Yusaku

doi:10.1097/rlu.0b013e3181b5363b

Cited by 3 publications

(5 citation statements)

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“…Hydronephrosis was evaluated by ultrasound and divided into 4 grades. 18 The tumor-node-metastasis classification system was used for staging, 19 the ASA physical status classification system was used to quantify the anesthetic risk of concomitant disease, 20 and a modified Clavien classification system was used to evaluate postoperative complications. 21 …”

Section: Methodsmentioning

confidence: 99%

Modified Tubeless Ureterocutaneostomy in High-Risk Patients After Radical Cystectomy and its Long-Term Clinical Outcomes

Li,

Fu,

et al. 2023

Technol Cancer Res Treat

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Objectives This work aimed to prevent stoma stenosis and achieve tubeless cutaneous ureterostomy in elderly and high-risk patients with our modified cutaneous ureterostomy. Methods We retrospectively analyzed 40 and 49 patients (176 renal units) who underwent Toyoda (group 1) and modified cutaneous ureterostomy (group 2) between 2012 and 2021. The average follow-up period was 44 months. The primary results of our study were the catheter-free rate and clinical outcomes, especially renal function and urinary diversion-related complications. Significant differences in catheter-free rate and urinary diversion-related complications were found between our modified method and the Toyoda technique. Results A total of 56 (71.8%) of 78 renal units in group 1 and 89 (90.8%) of 98 renal units in group 2 remained catheter free. Compared with group 1, group 2 had a higher catheter-free rate ( P = .001). Multivariate analysis indicated that the surgical procedure (HR = 0.268; P = .001) and body mass index (HR = 3.127; P = .002) were the predictors independently associated with catheter insertion. During follow-up, renal deterioration was observed in 32 (36.0%) patients. Patients with catheter insertion were more likely to suffer from renal deterioration ( P < .001), postoperative pyelonephritis ( P < .001), and urolithiasis ( P < .001) than their counterparts. Conclusion Our modified cutaneous ureterostomy method may provide an effective and simple approach to tubeless cutaneous ureterostomy in elderly and high-risk patients.

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Section: Methodsmentioning

confidence: 99%

Modified Tubeless Ureterocutaneostomy in High-Risk Patients After Radical Cystectomy and its Long-Term Clinical Outcomes

Li,

Fu,

et al. 2023

Technol Cancer Res Treat

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“…After the surgery, a 6-Fr single-J stent was placed in the renal pelvis through the stoma. In all cases, the single-J stents were exchanged every 4 weeks and were removed 3 months after the surgery, because the stomal conditions were unstable and obstructive in the early phases after the surgery [9,10]. …”

Section: Methodsmentioning

confidence: 99%

Evaluations for Hydronephrosis After the Establishment of Tubeless Cutaneous Ureterostomy

2013

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PurposeTo investigate hydronephrosis after the establishment of tubeless cutaneous ureterostomy by using our definition of the tubeless condition and our indications for catheter insertion.Materials and MethodsTwenty-eight (54 renal units) patients with both establishment of tubeless cutaneous ureterostomy 3 months after surgery and at least 12 months of follow-up were investigated in this study. The 4-grade system was used to evaluate the hydronephrosis. The definition of the tubeless condition in cutaneous ureterostomy was as follows: 1) the catheter stent is not placed in the renal pelvis through the stoma, 2) the grade of hydronephrosis is less than 3, and 3) the kidney is functioning. Indications for catheter insertion after the establishment of tubeless cutaneous ureterostomy were as follows: 1) difficulty in curing acute pyelonephritis by drug treatments, 2) flank pain due to hydronephrosis, or 3) increase in the grade of hydronephrosis.ResultsThe follow-up period was 12 to 78 months (average, 40.5±22.1 months). After the establishment of tubeless cutaneous ureterostomy, 6 of 54 renal units (11.1%) were eligible for catheter insertion. The catheter insertion was performed in 4 renal units. Another 2 renal units were followed up without intervention, and they gradually became atrophic. The renal functions were preserved in the other 52 renal units.ConclusionsOur results suggest that our definition of the tubeless condition and our indications for catheter insertion would be useful for the evaluation and management of hydronephrosis after establishment of tubeless cutaneous ureterostomy.

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“…After surgery, a 6-Fr single-J stent was placed in the renal pelvis through the stoma in all patients. In all cases, the single-J stents were exchanged every 4 weeks and were removed 3 months after surgery, because the stomal conditions were unstable and obstructive in the early phase after surgery [10,12]. Stomal conditions were evaluated with excretory urography at 3 and 6 months after the surgery and with MAG3 diuretic renography at 3 months after the surgery.…”

Section: Methodsmentioning

confidence: 99%

“…The protocol for MAG3 diuretic renography for CU was described previously [10]. In brief, 60 minutes before scanning, patients were infused with 500 mL normal saline solution intravenously for hydration.…”

Section: Methodsmentioning

confidence: 99%

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Diagnostic Criteria for Stomal Obstruction of Tubeless Cutaneous Ureterostomy by Use of^99mTc-Mercaptoacetyltriglycine Diuretic Renography

2013

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PurposeTo evaluate 99mTc-mercaptoacetyltriglycine diuretic renograms for diagnosing stomal obstruction in tubeless cutaneous ureterostomy.Materials and MethodsCutaneous ureterostomy was performed in 29 patients (56 renal units) with a minimum follow-up period of 12 months. Stomal obstruction was evaluated with 99mTc-mercaptoacetyltriglycine diuretic renography 3 months after surgery. Regions of interest were drawn that completely encircled and snugly fit the kidney, renal pelvis, and ureter. The data analyses were performed with half-times to tracer clearance following furosemide (0.5 mg/kg) administration.ResultsThe mean half-times to tracer clearance were 6.90±6.30, 5.25±4.29, and 8.75±7.63 minutes in the total, ipsilateral, and contralateral kidneys, respectively, in side relationships between the ureter and the stoma. There were significant differences between the ipsilateral and contralateral kidneys in the mean half-time to tracer clearance (p=0.038). Forty-eight renal units (85.7%) had a half-time to tracer clearance of less than 15 minutes, and all 48 renal units had no hydronephrosis. On the other hand, 5 renal units (8.9%) had a half-time to tracer clearance of more than 20 minutes, and these 5 renal units required the insertion of stent catheters or became atrophic.Conclusions99mTc-mercaptoacetyltriglycine diuretic renography was very useful for diagnosing stomal obstruction of tubeless cutaneous ureterostomy. The upper limit of the half-time to tracer clearance for unobstructed systems was 15 minutes, which allowed for the confident exclusion of stomal obstruction in tubeless cutaneous ureterostomy.

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Evaluation of Hydronephrosis With Tubeless Cutaneous Ureterostomy Using Tc-99m MAG3 Diuretic Renography

Abstract: Tc-99m MAG3 diuretic renography with T1/2 assessment is useful to evaluate stomal stenosis in tubeless cutaneous ureterostomy.

Cited by 3 publications

References 13 publications

Modified Tubeless Ureterocutaneostomy in High-Risk Patients After Radical Cystectomy and its Long-Term Clinical Outcomes

Modified Tubeless Ureterocutaneostomy in High-Risk Patients After Radical Cystectomy and its Long-Term Clinical Outcomes

Evaluations for Hydronephrosis After the Establishment of Tubeless Cutaneous Ureterostomy

Diagnostic Criteria for Stomal Obstruction of Tubeless Cutaneous Ureterostomy by Use of^99mTc-Mercaptoacetyltriglycine Diuretic Renography

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Evaluation of Hydronephrosis With Tubeless Cutaneous Ureterostomy Using Tc-99m MAG3 Diuretic Renography

Abstract: Tc-99m MAG3 diuretic renography with T1/2 assessment is useful to evaluate stomal stenosis in tubeless cutaneous ureterostomy.

Cited by 3 publications

References 13 publications

Modified Tubeless Ureterocutaneostomy in High-Risk Patients After Radical Cystectomy and its Long-Term Clinical Outcomes

Modified Tubeless Ureterocutaneostomy in High-Risk Patients After Radical Cystectomy and its Long-Term Clinical Outcomes

Evaluations for Hydronephrosis After the Establishment of Tubeless Cutaneous Ureterostomy

Diagnostic Criteria for Stomal Obstruction of Tubeless Cutaneous Ureterostomy by Use of99mTc-Mercaptoacetyltriglycine Diuretic Renography

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Diagnostic Criteria for Stomal Obstruction of Tubeless Cutaneous Ureterostomy by Use of^99mTc-Mercaptoacetyltriglycine Diuretic Renography