Karim R, Sengupta S, Samanta S, Aich R K, Das U, Deb P
Department of Radiodiagnosis, Institute of Postgraduate Medical Education & Research (IPGMER), Kolkata, West Bengal, India.
Indian J Nephrol. 2010 Apr;20(2):84-8. doi: 10.4103/0971-4065.65301.
Percutaneous nephrostomy is the procedure of establishing a temporary drainage tract of the renal pelvi-calyceal system through the skin. This study aims to find out whether low cost trocar catheter can be a suitable substitute for the relatively high cost fluoroscopy/ultrasonography guided tract dilatation and tube insertion procedure. Percutaneous nephrostomy by the trocar catheter was performed in 126 patients. Under local anesthesia, a stab wound deep enough to traverse the muscle layer was made through which the trocar - catheter drainage set was inserted under ultrasonography guidance. About 179 procedures were performed in 126 patients. Primary technical success rate was 94%, major complication rate 1.6%, minor complication rate 11% and catheter related complications like catheter blockage or dislodgement were 13%. There was no procedure related mortality in our series. The ultrasonography-guided trocar, catheter nephrostomy, is a quick, safe and low cost procedure in selected cases of upper urinary tract obstruction. The primary technical success and complication rates are comparable to any other reported procedure and its low cost is particularly suitable for developing countries like India.
经皮肾造瘘术是一种通过皮肤建立肾盂肾盏系统临时引流通道的手术。本研究旨在探究低成本的套管针导管是否可成为相对高成本的荧光透视/超声引导下通道扩张及置管手术的合适替代方案。126例患者接受了套管针导管经皮肾造瘘术。在局部麻醉下，做一个足够深以穿过肌肉层的刺伤切口，然后在超声引导下插入套管针导管引流装置。126例患者共进行了约179次手术。主要技术成功率为94%，主要并发症发生率为1.6%，次要并发症发生率为11%，导管相关并发症如导管堵塞或移位的发生率为13%。我们的系列研究中无手术相关死亡病例。超声引导下套管针导管肾造瘘术在选择性上尿路梗阻病例中是一种快速、安全且低成本的手术。其主要技术成功率和并发症发生率与其他任何已报道的手术相当，且低成本尤其适合像印度这样的发展中国家。
