Document Detail


Combined CT- and fluoroscopy-guided nephrostomy in patients with non-obstructive uropathy due to urine leaks in cases of failed ultrasound-guided procedures.
MedLine Citation:
PMID:  20971592     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
AIM: To report our experience of combined CT- and fluoroscopy-guided nephrostomy in patients with non-obstructive uropathy due to urine leaks in cases of failed ultrasound-guided procedures.
PATIENTS AND METHODS: Eighteen patients (23 kidneys) with non-obstructive uropathy due to urine leaks underwent combined CT- and fluoroscopy-guided nephrostomy. All procedures were indicated as second-line interventions after failed ultrasound-guided nephrostomy. Thirteen males and five females with an age of 62.3±8.7 (40-84) years were treated. Urine leaks developed in majority after open surgery, e.g. postoperative insufficiency of ureteroneocystostomy (5 kidneys). The main reasons for failed ultrasound-guided nephrostomy included anatomic obstacles in the puncture tract (7 kidneys), and inability to identify pelvic structures (7 kidneys). CT-guided guidewire placement into the collecting system was followed by fluoroscopy-guided nephrostomy tube positioning. Procedural success rate, major and minor complication rates, CT-views and needle passes, duration of the procedure and radiation dose were analyzed.
RESULTS: Procedural success was 91%. Major and minor complication rates were 9% (one septic shock and one perirenal abscess) and 9% (one perirenal haematoma and one urinoma), respectively. 30-day mortality rate was 6%. Number of CT-views and needle passes were 9.3±6.1 and 3.6±2.6, respectively. Duration of the complete procedure was 87±32min. Dose-length product and dose-area product were 1.8±1.4Gycm and 3.9±4.3Gycm(2), respectively.
CONCLUSIONS: Combined CT- and fluoroscopy-guided nephrostomy in patients with non-obstructive uropathy due to urine leaks in cases of failed ultrasound-guided procedures was feasible with high technical success and a tolerable complication rate.
Authors:
C M Sommer; J Huber; B A Radeleff; W Hosch; U Stampfl; B M Loenard; P Hallscheidt; A Haferkamp; H U Kauczor; G M Richter
Publication Detail:
Type:  Journal Article     Date:  2010-10-23
Journal Detail:
Title:  European journal of radiology     Volume:  80     ISSN:  1872-7727     ISO Abbreviation:  Eur J Radiol     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-11-07     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8106411     Medline TA:  Eur J Radiol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  686-91     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany.
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