Mehmet ŞEKER, Türkmen Turan ÇİFTÇİ, Devrim AKINCI, Okan AKHAN

Görüntüleme kılavuzluğunda perkütan nefrostomi: 6 yıllık tek merkez deneyimi

Amaç: Perkütan nefrostomilerin, endikasyonlarını, altta yatan patolojileri, teknik başarı oranını, komplikasyonları ve genel faydalarını retrospektif olarak incelemek.Materyal ve Metod: Ocak 1999 ile Aralık 2004 tarihleri arasında görüntüleme kılavuzluğunda perkütan nefrostomi yapılan 578 hastanın verileri retrospektif olarak incelenmiştir. Hastaların ortalama yaşı 42,5 yıl idi (6 gün–90 yıl). İşlem endikasyonları üriner enfeksiyon olmadan obstrüksiyon varlığı (% 77,9), üriner enfeksiyon ile beraber obstrüksiyon varlığı (%13,1), üriner diversiyon (%6,9) ve böbrek fonksiyonları değerlendirme (%2,1) idi. Bulgular: Teknik başarı oranı % 99,4 idi. İşlemle ilişkili mortalite izlenmedi. Çocuklarda major hemoraji ya da sepsis görülmemişti. Erişkin hastalarda major kanama oranı % 1,55, sepsis oranı ise %2,65 idi. Kateter dislokasyonu en sık ortaya çıkan komplikasyondu ve oranı toplamda %11,4 idi. Hastaların %7,2'sinde başka girişim yapılmadan perkütan nefrostomi ile başarılı tedavi sağlandı. Hastaların %36,5'inde cerrahi ile ve %14,7'sinde ise üreteral stent yerleştirilerek kesin tedavi sağlandı. Sonuç: Radyoloji kılavuzluğunda yapılan perkütan nefrostomi, yüksek teknik başarı ve düşük komplikasyon oranları ile çok çeşitli endikasyonlarda etkili ve güvenli bir şekilde kullanılabilir.

Anahtar Kelimeler:

Perkütan nefrostomi, üriner sistem obstrüksiyonu, üriner sistem kaçağı, üriner fistül, girişimsel radyoloji

Radiologically guided percutaneous nephrostomy: A 6-year single-center experience

Aim: To retrospectively analyze the indications, underlying pathologies, technical success rate, complications and benefit of percutaneous nephrostomies in a single centre.Materials and Methods: Data of 578 patients who underwent radiologically guided percutaneous nephrostomy between January 1999 and December 2004 were retrospectively reviewed. The mean age of the patients was 42.5 years (range, 6 days–90 years). The indications were urinary obstruction without urinary infection (77.9%), urinary obstruction with urinary infection (13.1%), urinary diversion (6.9%) and diagnostic testing (2.1%). Results: The technical success rate was 99.4%. There was no procedure related mortality. Major hemorrhage or sepsis were not observed in children. Major hemorrhage occurred in 1.55% and sepsis occured in 2.65% of adult patients. Catheter dislodgement was the commonest complication with an overall rate of 11.4%. In 7.2% patients, percutaneous nephrostomy was successful in managing patients without further intervention. 36.5% of patients had surgery and 14.7% had ureteral stenting as deﬁnitive treatment. Conclusion: Radiologically guided percutaneous nephrostomy, can be used effectively, and safely in a wide variety of indications with high technical success and low complications rates.

Keywords:

Percutaneous nephrostomy, urinary system obstruction, urinary leakage, urinary fistula, interventional radiology,

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