Introduction: The aim of the study is to describe intermittent drainage via percutaneous nephrostomy tubewith simultaneous laparoscopic nephrectomy (LN) as a more feasible technique in giant hydronephrosis (GH).Materials and Methods: All of the patients with GH who underwent LN between March 2016 and December2019 in our tertiary center were retrospectively evaluated. Patient demographics, perioperative data, surgi cal technique, complications, and results were described. Ultrasound-guided percutaneous nephrostomycatheter was inserted on the operating table in order to provide collector system decompression. 20–30% ofthe measured volume was evacuated, and nephrostomy was clamped. As the renal sac was partially emp tied, it contributed to the renal sac and other abdominal organs preservation during trocar insertion. 0–15%more urinary drainage was performed through nephrostomy in cases where the colon could not be assessedclearly with direct vision. During dissection, since the renal sac was partially filled, orientation was main tained and the renal pedicle was reached. In addition, it could be detected more easily in aberrant vessels.The remaining steps were similar to conventional transperitoneal LN.Results: The total number of the participants was 11, four female, and seven male, with a mean age of 25.6 ±6.9 years. The mean surgical intervention time was 72.7±16.9 min. The mean urine volume discharged fromthe kidney was 2331.8±760 ml. Hospitalization time was, on average, 3.5±0.6 days. Clavien 1 complicationoccurred only in one patient. There was no observed any complication-related nephrostomy.Conclusion: This procedure is an easier way of dealing with a complicated surgical challenge. Intermittentdrainage by percutaneous nephrostomy tube with simultaneous LN for GH is technically feasible and safefor selected patients. ">
[PDF] Easier laparoscopic surgery in giant hydronephrosis: Intermittent drainage by percutaneous nephrostomytube with simultaneous laparoscopic nephrectomy | [PDF] Easier laparoscopic surgery in giant hydronephrosis: Intermittent drainage by percutaneous nephrostomytube with simultaneous laparoscopic nephrectomy
Introduction: The aim of the study is to describe intermittent drainage via percutaneous nephrostomy tubewith simultaneous laparoscopic nephrectomy (LN) as a more feasible technique in giant hydronephrosis (GH).Materials and Methods: All of the patients with GH who underwent LN between March 2016 and December2019 in our tertiary center were retrospectively evaluated. Patient demographics, perioperative data, surgi cal technique, complications, and results were described. Ultrasound-guided percutaneous nephrostomycatheter was inserted on the operating table in order to provide collector system decompression. 20–30% ofthe measured volume was evacuated, and nephrostomy was clamped. As the renal sac was partially emp tied, it contributed to the renal sac and other abdominal organs preservation during trocar insertion. 0–15%more urinary drainage was performed through nephrostomy in cases where the colon could not be assessedclearly with direct vision. During dissection, since the renal sac was partially filled, orientation was main tained and the renal pedicle was reached. In addition, it could be detected more easily in aberrant vessels.The remaining steps were similar to conventional transperitoneal LN.Results: The total number of the participants was 11, four female, and seven male, with a mean age of 25.6 ±6.9 years. The mean surgical intervention time was 72.7±16.9 min. The mean urine volume discharged fromthe kidney was 2331.8±760 ml. Hospitalization time was, on average, 3.5±0.6 days. Clavien 1 complicationoccurred only in one patient. There was no observed any complication-related nephrostomy.Conclusion: This procedure is an easier way of dealing with a complicated surgical challenge. Intermittentdrainage by percutaneous nephrostomy tube with simultaneous LN for GH is technically feasible and safefor selected patients. ">
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