İbrahim KELEŞ, Mustafa KARALAR, Emre KAÇAR, Ebru ÜNLÜ, Çınar BALÇIK, Rukan KARACA, Ömer Fatih NAS

Kombine ultrasonografi ve floroskopi kullanılarak gerçekleştirilen perkütan nefrostominin etkinliği: 87 olgunun retrospektif analizi

Amaç: Bu çalışmada kombine ultrasonografi (USG) ve floroskopi kullanılarak gerçekleştirilen perkütan nefrostomi (PN) işleminin etkinliğini değerlendirmeyi amaçladık.Yöntemler: Temmuz 2011 ile Mayıs 2015 tarihleri arasında USG ve floroskopi kombinasyonu ile 106 PN işlemi gerçekleştirilen 87 hasta (48 kadın, 39 erkek; ortalama yaş, 58,2; yaş aralığı, 19 ? 91) retrospektif olarak incelendi. İşlem sonrası nefrostomi kateterinin renal pelviste yerleşimi ve spontan idrar drenajı teknik başarı olarak kabul edildi. Tüm hastalar işlemden önce profilaktik antibiyotik aldı ve her hastada pıhtılaşma parametreleri ve trombosit sayısı işlemden önce kontrol edildi. İşleme bağlı komplikasyonlar majör, minör ve katetere bağlı komplikasyonlar olarak sınıflandırıldı. PN işleminin teknik başarı ve komplikasyon oranları hesaplandı.Bulgular: PN 47 hastada (%54) benign nedenlerle, 40 hastada (%46) malign nedenlerle gerçekleştirildi. PN uygulanan 101 renal sistem (%95,1) dilate iken, 5 renal sistemde (%4,9) dilatasyon yoktu. Yüz altı PN işleminin 104'ünde (%98,1) teknik başarı elde edildi. Hastaların hiçbirinde majör komplikasyon gözlenmedi. On bir hastada (%12,6) geçici hematüri şeklinde minör komplikasyon görüldü. On bir hastada (%12,6) kateter çıkması saptandı. Sonuç: Üriner sistemin dekompresyonu ve diversiyonunda kombine USG ve floroskopi ile gerçekleştirilen PN uygulaması, yüksek teknik başarı ve düşük komplikasyon oranları ile etkili ve güvenilir bir seçenektir.

The efficacy of percutaneous nephrostomy performed by using combined ultrasonography and fluoroscopy: Retrospective analysis of 87 cases

Objective: We aimed to evaluate the efficacy of the percutaneous nephrostomy (PN) performed by using combined ultrasonography (USG) and fluoroscopy.Methods: Eighty-seven patients who underwent 106 PN procedures performed by using USG and fluoroscopy combination between July 2011 and May 2015 were retrospectively analyzed. The technical success was considered if nephrostomy catheter was placed within renal pelvis and functioned spontaneously. All patients received preprocedural prophylactic antibiotic and preprocedural coagulation parameters and platelet count were tested in all patients routinely. The procedural complications are classified as major, minor and catheter-related. The technical success rates and complication rates of the PN procedure were calculated. Results: PN was performed for benign causes in 47 patients (54%) and for malignant causes in 40 patients (46%). A total of 106 nephrostomies were performed in 101 kidneys (95.1%) with dilated systems and in 5 kidneys (4.9%) with non-dilated systems. The technical success rate of PN was 98.1% (104/106 PN procedures). Major complication was not observed in any patients. Transient hematuria as a minor complication was seen in 11 patients (12.6%). Catheter dislodgement occurred in 11 patients (12.6%).Conclusion: The PN performed by using combined USG and fluoroscopy is effective and reliable procedure in urinary decompression and diversion with high success and low complication rates. J Clin Exp Invest 2015; 6 (2): 170.

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