Adem TUNÇEKİN, Mehmet DEMİR, Eyyup Sabri PELİT, İsmail YAĞMUR, Bülent KATI, İbrahim Halil ALBAYRAK, Halil ÇİFTÇİ

Üroloji pratiğinde acil perkütan nefrostominin yeri; tek merkez deneyimi

Amaç: Bu çalışmada perkütan nefrostominin üroloji pratiğindeki önemini değerlendirmeyi amaçladık.Gereç ve Yöntemler: Ocak 2014 ile Ocak 2021 yılları arasında üroloji kliniğinde perkütan nefrostomi takılan hastaların kayıtları retrospektif olarak incelendi. Pyonefroz ve/veya böbrek fonksiyon testi yüksekliği tespit edilen ve acil şartlarda ürologlar tarafından perkütan nefrostomi takılan hastalar çalışmaya dahil edildi. Hastaların yaşları, hastaneye başvuru nedenleri, hidronefroz derecesi, primer patolojileri, işlem sonrası komplikasyonlar ve işlem sonrası yapılan elektif tedavileri değerlendirildi.Bulgular: Çalışmaya dahil edilen 164 hastanın 98’i erkek ve 66’sı kadındı. Hastaların ortalama yaşı 47,45 (18-90) yıl idi. Hastaların 120’sine tek taraflı, 44’üne ise bilateral olmak üzere toplam 208 renal üniteye perkütan nefrostomi katateri takıldı. 208 renal ünitenin 192’sinde (%95,2) perkütan nefrostomi başarılı bir şekilde takılırken, 10 (%4,8) renal ünitede işlem başarısız oldu ve ek girişim gerekti. Hastaların %40,2’sine onkolojik nedenlerden, %59,8’ine ise onkolojik dışı nedenlerden perkütan nefrostomi kateteri takıldı. İşlem sonrası minör komplikasyonlardan en sık görüleni transfüzyon gerektirmeyen geçici hematüri (%3,2) olup, ateş (%2,4), işlem sonrası devam eden ağrı (%1,6), kateter tıkanması (%0,8) ve geçici idrar sızıntısı (%0,8) diğer minör komplikasyonlardı. Majör komplikasyonlardan ise en sık görüleni ise nefrostominin yerinden çıkması (%3,2) idi.Sonuç: Perkütan nefrostomi obstrüktif üropati, pyonefroz tedavisi ve üriner diversiyon amacıyla uygulanan, yüksek başarı oranına sahip, etkili ve güvenli bir yöntemdir. Son zamanlarda girişimsel radyologlar tarafından daha fazla uygulanıyor olsa da ürologlar tarafından da başarılı bir şekilde uygulanabilmektedir.

Anahtar Kelimeler:

Obstrüktif üropati, Hidronefroz, Perkütan nefrostomi, Komplikasyon

Place of emergency percutaneous nephrostomy in urology practice: single center experience

Objective: The aim of this study was to evaluate the importance of percutaneous nephrostomy in urology practice.Material and Methods: Records of patients who underwent percutaneous nephrostomy at the urology clinic between January 2014 and January 2021 were retrospectively examined. Patients with pyonephrosis and/or renal function elevation who underwent percutaneous nephrostomy by urologists in emergency conditions were included in the study. Age, reasons for hospital admission, the degree of hydronephrosis, primary pathologies, postoperative complications, and postoperative elective treatments were evaluated.Results: Of the 164 patients included in the study, 98 were male and 66 were female. The mean age of the patients was 47.45 (18-90) years. Percutaneous nephrostomy catheter was inserted into a total of 208 renal units, 120 of which were unilateral and 44 of which were bilateral. Percutaneous nephrostomy was successfully inserted in 192 (95.2%) of 208 renal units, while the procedure failed in 10 (4.8%) renal units and additional intervention was required. Percutaneous nephrostomy catheter was inserted in 40.2% of patients for oncological reasons and 59.8% for non-oncological reasons. The most common minor complications after the procedure were transient hematuria not requiring transfusion (3.2%), fever (2.4%), ongoing pain after the procedure (1.6%), catheter obstruction (0.8%), and temporary urine leakage (0.8%). The most common major complication was nephrostomy dislodgement (3.2%).Conclusion: Percutaneous nephrostomy is an effective and safe method with a high success rate that can be applied for obstructive uropathy and pyonephrosis treatment and urinary diversion. Although the procedure is performed mostly by interventional radiologists, it can also be performed successfully by urologists.

Keywords:

Obstructive uropathy, Hydronephrosis, Percutaneous nephrostomy, Complication,

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Yayın Aralığı: Yılda 3 Sayı
Başlangıç: 2020
Yayıncı: ENDOÜROLOJİ DERNEĞİ

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