Is the Routine Check Nephrostogram Following Percutaneous Antegrade Ureteric Stent Placement Necessary?
| Autor: | Shueh En Lin, Keng Chuan Soh, Austin M M Htoo, Richard Hg Lo, Kiang Hiong Tay, Bien Soo Tan |
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| Rok vydání: | 2007 |
| Předmět: |
Adult
Male medicine.medical_specialty Percutaneous medicine.medical_treatment Radiology Interventional Unnecessary Procedures Kidney Prosthesis Design Risk Assessment Severity of Illness Index Cohort Studies medicine Humans Radiology Nuclear Medicine and imaging Ureteric stent Hydronephrosis Survival rate Aged Nephrostomy Percutaneous Retrospective Studies Aged 80 and over Postoperative Care medicine.diagnostic_test Diagnostic Tests Routine business.industry Stent Interventional radiology Retrospective cohort study Middle Aged medicine.disease Surgery Radiography Survival Rate Treatment Outcome surgical procedures operative Nephrostomy Female Stents Radiology Urinary Catheterization Cardiology and Cardiovascular Medicine business Follow-Up Studies Ureteral Obstruction |
| Zdroj: | CardioVascular and Interventional Radiology. 31:604-609 |
| ISSN: | 1432-086X 0174-1551 |
| DOI: | 10.1007/s00270-007-9128-0 |
| Popis: | Our aim was to review our experience with percutaneous antegrade ureteric stent (PAUS) placement and to determine if the routinely conducted check nephrostogram on the day following ureteric stent placement was necessary. Retrospective review of patients who had undergone PAUS placement between January 2004 and December 2005 was performed. There were 83 subjects (36 males, 47 females), with a mean age of 59.9 years (range, 22-94 years). Average follow-up duration was 7.1 months (range, 1-24 months). The most common indications for PAUS placement were ureteric obstruction due to metastatic disease (n = 56) and urinary calculi (n = 34). Technical success was 93.2% (96/103 attempts), with no major immediate procedure-related complications or mortalities. The Bard 7Fr Urosoft DJ Stent was used in more than 95% of the cases. Eighty-one of 89 (91.0%) check nephrostograms demonstrated a patent ureteric stent with resultant safety catheter removal. Three check nephrostograms revealed distal stent migration requiring repositioning by a goose-snare, while five others showed stent occlusion necessitating permanent external drainage by nephrostomy drainage catheter reinsertion. Following PAUS placement, the serum creatinine level improved or stabilized in 82% of patients. The serum creatinine outcome difference between the groups with benign and malignant indications for PAUS placement was not statistically significant (p = 0.145) but resolution of hydronephrosis was significantly better (p = 0.008) in patients with benign indications. Percutaneous antegrade ureteric stent placement is a safe and effective means of relief for ureteric obstruction. The check nephrostogram following ureteric stent placement was unnecessary in the majority of patients. |
| Databáze: | OpenAIRE |
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