Percutaneous Obliteration of Urinary Leakage after Partial Nephrectomy Using N-Butyl-Cyanoacrylate Obliteration of the Urinoma with or without Coil Embolization of the Fistula Tract.

Autor:	Nouri YM; Department of Radiology, King Fahad Hospital, Jeddah Ministry of Health, Jeddah, Saudi Arabia., Chu HH; Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Olympic-ro 43gil, Seoul, Korea., Shin JH; Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Olympic-ro 43gil, Seoul, Korea. Electronic address: jhshin@amc.seoul.kr., Tsauo J; Department of Interventional Therapy, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China., Kim CS; Department of Urology, University of Ulsan College of Medicine, Asan Medical Center, Olympic-ro 43gil, Seoul, Korea., Hong BS; Department of Urology, University of Ulsan College of Medicine, Asan Medical Center, Olympic-ro 43gil, Seoul, Korea., Kim JW; Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Olympic-ro 43gil, Seoul, Korea., Kim JH; Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Olympic-ro 43gil, Seoul, Korea.
Jazyk:	angličtina
Zdroj:	Journal of vascular and interventional radiology : JVIR [J Vasc Interv Radiol] 2019 Dec; Vol. 30 (12), pp. 2002-2008. Date of Electronic Publication: 2019 Aug 13.
DOI:	10.1016/j.jvir.2019.05.019
Abstrakt:	Purpose: To retrospectively evaluate the safety and efficacy of the percutaneous obliteration of urinary leakage after partial nephrectomy (PN) using coils and N-butyl-cyanoacrylate (NBCA). Materials and Methods: Data of 10 consecutive patients who underwent percutaneous obliteration of urinary leakage after PN using coil and NBCA between February 2016 and May 2018 were retrospectively reviewed. A urinary fistulography was performed via the drainage catheter. If the fistulous tract was clearly visualized, super-selective embolization of the fistulous tract with coils and urinoma cavity sealing with NBCA was performed. In cases where the fistulous tract could not be clearly visualized, only urinoma cavity sealing was performed. Outcomes and complications were assessed by reviewing medical records and computed tomography (CT). Results: In 7 (70%) patients who showed obvious urinary fistulous tract, coil embolization of the urinary fistulous tract, followed by sealing of the urinoma cavity with NBCA, was performed. Obliteration of the urinoma without coil embolization of the fistula tract was performed in 3 patients (30%) in whom a distinct fistulous tract could not be visualized. The median number of treatment sessions required to achieve clinical success was 1 (range, 1-5). Four patients underwent multiple repeated procedure with successful results. All patients showed gradual decrease in size or complete disappearance of urinoma on follow-up CT without evidence of urinary leakage during the follow-up period (mean, 44.6 weeks; range, 11-117 weeks). There were no procedure-related complications. Conclusions: Percutaneous obliteration of urinary leakage after PN using coils and NBCA is safe and effective. (Copyright © 2019 SIR. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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