Percutaneous nephrostomy: a series and review of the literature

Stables, Derek P.; Ginsberg, N.; Johnson, Mayo

doi:10.2214/ajr.130.1.75

Cited by 195 publications

(43 citation statements)

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“…Fueled by technologi cal advances, the ability to rapidly and safely cre ate access to the urinary tract has spawned the field of minimally invasive urologic therapy and altered the day-to-day practice of urology (2)(3)(4)(5)(6). This review presents, in stepwise fashion, the technique of percutaneous nephrostomy and the extensions of this basic technique to other appli cations in the urinary tract.…”

Section: Introductionmentioning

confidence: 99%

Percutaneous Nephrostomy with Extensions of the Technique: Step by Step

Dyer¹,

Regan²,

Kavanagh³

et al. 2002

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Minimally invasive therapy in the urinary tract begins with renal access by means of percutaneous nephrostomy. Indications for percutaneous nephrostomy include urinary diversion, treatment of nephrolithiasis and complex urinary tract infections, ureteral intervention, and ne phroscopy and ureteroscopy. Bleeding complications can be minimized by entering the kidney in a relatively avascular zone created by branch ing of the renal artery. The specific site of renal entry is dictated by the indication for access with consideration of the anatomic constraints. Successful percutaneous nephrostomy requires visualization of the col lecting system for selection of an appropriate entry site. The definitive entry site is then selected; ideally, the entry site should be subcostal and lateral to the paraspinous musculature. Small-bore nephrostomy tracks can be created over a guide wire coiled in the renal pelvis. A large-diameter track may be necessary for percutaneous stone therapy, nephroscopy, or antegrade ureteroscopy. The most common extension of percutaneous nephrostomy is placement of a ureteral stent for treat ment of obstruction. Transient hematuria occurs in virtually every pa tient after percutaneous nephrostomy, but severe bleeding that requires transfusion or intervention is uncommon. In patients with an ob structed urinary tract complicated by infection, extensive manipula tions pose a risk of septic complications.

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Section: Introductionmentioning

confidence: 99%

Percutaneous Nephrostomy with Extensions of the Technique: Step by Step

Dyer¹,

Regan²,

Kavanagh³

et al. 2002

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127

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“…On the whole, percutaneous nephrostomy insertion is a relatively safe procedure when it is performed by well-trained and very-skilled interventional radiologists. Nevertheless, a number of complications associated with nephrostomy insertion have been reported by some authors [4,5] as follows: (1) Major complications were reported in 4% to 8% of cases and these included significant bleeding requiring blood transfusion, septicemia; and inadvertent puncturing of pleura or viscera for example the liver, colon, and spleen; (2) minor complications were reported in 3% to 15% of cases and these include retroperitoneal extravasation of urine and significant visible hematuria causing clot colic and/or catheter blockage requiring further investigations.…”

Section: Discussionmentioning

confidence: 99%

Ante-grade ureteric stenting, retrospective experience in managing 89 patients: Indications, complications and outcome

Venyo

Hanley

Barrett

et al. 2014

JBGC

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Background: Over the past three decades there has been a remarkable increase in interventional uro-radiological procedures in the developed countries. Long-term drainage of the obstructed upper urinary tract may be achieved by percutaneous nephrostomy or ureteric stenting. Previously most ureteric stents were inserted by the retrograde approach at cystoscopy and these procedures have required the use of general or spinal anesthesia. With the development of a nephrostomy service in most hospitals throughout the world ante-grade ureteric stenting procedures are being carried out by trained interventional radiologists in the radiology department without the need for a general or spinal anesthesia. Aims/materials and methods:To review the records of all 89 patients who had insertion of ante-grade ureteric stents for ureteric obstruction between February 2010 and January 2013 in order to document the following: The causes of obstruction; The side (left, right or both sides) and site of the ureteric obstruction (upper, mid or lower ureter); The sex and ages of the patients; Success or failure of the procedure; Complications of procedure; The management of the complications.Results: Ante-grade ureteric stenting was successful in 105 out of 121 procedures (86.7%) which 89 patients underwent. Out of 105 successful ante-grade stenting procedures carried out, 103 were successful at first attempt, another two were successful at second attempt and one successful at a third attempt, making it a total of 105 successful procedures. There were minimal complications. Conclusion and recommendation:Ante-grade ureteric stenting is a safe procedure with minimal complications. Every radiology unit should have a trained interventional radiologist capable of performing ante-grade ureteric stenting.

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“…False positive imaging for the obstruction can be caused by parapelvic cyst, intrarenal pelvis, high urine flow state and vesicoureteral reflux. (Stables et al, 1978) …”

Section: Ultrasoundmentioning

confidence: 99%

Modern Surgical Treatments of Urinary Tract Obstruction

Lojanapiwat¹

2012

Chronic Kidney Disease

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Percutaneous nephrostomy: a series and review of the literature

Cited by 195 publications

References 1 publication

Percutaneous Nephrostomy with Extensions of the Technique: Step by Step

Percutaneous Nephrostomy with Extensions of the Technique: Step by Step

Ante-grade ureteric stenting, retrospective experience in managing 89 patients: Indications, complications and outcome

Modern Surgical Treatments of Urinary Tract Obstruction

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