Abdullah GEDİK, İlhan KILINÇ, Aylin Hasanefendioğlu BAYRAK, DAVUT AKIN, A. Ferruh AKAY

Obstrüktif üropatide ultrasonografi kılavuzluğunda perkütan nefrostomi

Ultrasonografi (USG) kılavuzluğunda perkütan nefrostomi (PN) uyguladığımız hastaları endikasyon ve komplikasyonlar yönünden retrospektif olarak değerlendirdik. Ocak 2002 ile Aralık 2005 arasında USG kılavuzluğunda PN uygulanan 371 hasta retrospektif olarak değerlendirildi. Hastaların demografik verileri, obstrüksiyon nedenleri, PN’ye bağlı minör ve majör komplikasyonları tartışıldı. Bu periyotta 371 hastaya toplam olarak 455 PN kondu (84 bilateral, 287 unilateral). Hastaların 113’ü (%30.45) bayan, 258’i (%69.55) erkek olup, yaşları 5 ay ile 85 yıl (ortalama 32.17 yıl) arasında değişmekteydi. Perkütan nefrostomi yerleştirilen hastalardan 17’sinde (%3.73) yapılan antegrad pyelografide kateterlerinin yerinde olmadığı saptandı. Genel başarı oranı %96.37 olarak bulundu. Obstrüksiyon sebebi 76 hastada malign hastalıklarken, 295 hastada benign hastalıklardı. Hastalardan 24’ünde (%6.46) majör komplikasyonlar gözlendi. Bunlar 7 hastada transfüzyon gerektiren makroskopik hematüri, 14 hastada sepsis ve 3 hastada iğneyle retroperitoneal kolona giriş meydana geldi. Hastalardan 51’inde (%13.74) minör komplikasyonlar olarak, kendiliğinden düzelen 24 saatten uzun sürmeyen makroskopik hematüri gözlendi. Sonuç olarak; obstrüktif üropatide ultrasonografi kılavuzluğunda perkütan nefrostominin emniyetli bir şekilde uygulanabileceğini ve üst üriner sistemi drene etmek için oldukça yararlı bir yöntem olduğunu düşünmekteyiz.

Ultrasound guided percutaneous nephrostomy for obstructive uropathy

We retrospectively evaluated the indications and complications in our patients that were performed of percutaneous nephrostomy applications with ultrasonography guidance. We evaluated 371 all patients whom applied percutaneous nephrostomy with ultrasonography guidance between January 2002 and December 2005 were evaluated retrospectively. The demographic data, cause of the obstruction, minor and major complications of patients were discussed. In this period, totally 455 Percutaneous nephrostomies (84 bilaterally, 287 unilaterally) in 371 patients (were placed in 113 females (30.45 %) and 258 males) were placed. The male (69.55%) patients whom mean age of the patients were 32.17 year (range 5 months to 85 years). In 17 of 371 (3.73%) patients, it was determined with antegrade pyelography that nephro stomy catheters were not in the kidney). Total success ratio was 96.37%. Causes of the obstructions were malignant diseases in for 76 patients (20.48%) and were benign diseases in for 295 patients (79.52%). The major complications were determined twenty-four of patients (6.46%). Major complications included macroscopic hematuria which needs transfusion (7 patients), septicemia (14 patients), and retroperitoneal colon perforation with needle (3 patients) were observed in 24 of the 371 patients. Minor complications were observed in 51 of the 371 patients (13.74 %). All of the minor complications were macroscopic hematuria that resolved in less than 24 hours. In conclusion, percutaneous nephrostomy with ultrasonography guidance were found as an effective and, safe and successful method for the drainage of upper urinary tract in the obstructive uropaty.

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