Document Detail


Is the routine check nephrostogram following percutaneous antegrade ureteric stent placement necessary?
MedLine Citation:
PMID:  17710479     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Keng Chuan Soh; Kiang Hiong Tay; Bien Soo Tan; Austin Mm Htoo; Richard Hg Lo; Shueh En Lin
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Publication Detail:
Type:  Journal Article     Date:  2007-08-21
Journal Detail:
Title:  Cardiovascular and interventional radiology     Volume:  31     ISSN:  1432-086X     ISO Abbreviation:  Cardiovasc Intervent Radiol     Publication Date:    2008 May-Jun
Date Detail:
Created Date:  2008-05-06     Completed Date:  2008-07-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8003538     Medline TA:  Cardiovasc Intervent Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  604-9     Citation Subset:  IM    
Affiliation:
Yong Loo Lin School of Medicine (MD11), National University of Singapore, 10 Medical Drive, Singapore 117597, Singapore.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Cohort Studies
Diagnostic Tests, Routine
Female
Follow-Up Studies
Humans
Kidney / radiography*
Male
Middle Aged
Nephrostomy, Percutaneous / instrumentation,  methods*
Postoperative Care / methods
Prosthesis Design
Radiology, Interventional / methods
Retrospective Studies
Risk Assessment
Severity of Illness Index
Stents*
Survival Rate
Treatment Outcome
Unnecessary Procedures*
Ureteral Obstruction / diagnosis,  mortality,  therapy*
Urinary Catheterization / methods

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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