Ahmed M, Lawal A T, Bello A, Sudi A, Awaisu M, Muhammad S, Oyelowo N, Tolani M, Hamza B K, Maitama H Y
Department of Surgery, Division of Urology, Ahmadu Bello University, Ahmadu Bello University Teaching Hospital, Zaria, Kaduna State, Nigeria.
Niger J Clin Pract. 2017 Dec;20(12):1622-1625. doi: 10.4103/njcp.njcp_138_17.
Obstructive uropathy is a common problem in urologic practice; temporary relief of obstruction in the upper tract poses a significant challenge. Ultrasound-guided percutaneous nephrostomy (PCN) is an option for upper tract drainage; compared to fluoroscopic guidance, it is readily available, affordable, and not associated with radiation exposure. We present our experience with ultrasound-guided PCN.
We studied all patients who had ultrasound-guided PCN in our center between January 2013 and January 2017. Information obtained included the patients' demographics, clinical details, primary pathology, indications, outcome, and complications within 30 days. Relevant data were extracted and analyzed using descriptive statistics.
A total number of 35 PCNs were performed in 26 patients within the period of study. The median age was 44.5 years. There were 17 females and 9 males. About 88.2% of the females had ureteric obstruction from advanced carcinoma of the cervix while the predominant cause of obstruction in the males was advanced carcinoma of the bladder. Kidney access under ultrasound guidance required well dilated collecting systems for success and ease of puncture. The most common complication was hematuria, which resolved within 24-48 h in all patients uneventfully.
PCN is an important and common procedure for temporary relief of upper urinary tract obstruction. While fluoroscopic guidance provides superior image guidance, ultrasound guidance is comparatively reliable, albeit with a longer learning curve. Adequate training, careful patients selection, and patience are key to success.
梗阻性尿路病是泌尿外科临床实践中的常见问题；上尿路梗阻的临时缓解是一项重大挑战。超声引导下经皮肾造瘘术（PCN）是上尿路引流的一种选择；与荧光镜引导相比，它易于实施、费用低廉且无辐射暴露风险。我们介绍我们在超声引导下PCN方面的经验。
我们研究了2013年1月至2017年1月期间在本中心接受超声引导下PCN的所有患者。获取的信息包括患者的人口统计学资料、临床细节、原发病理、适应证、结局以及30天内的并发症情况。提取相关数据并使用描述性统计学方法进行分析。
在研究期间，26例患者共进行了35次PCN。中位年龄为44.5岁。女性17例，男性9例。约88.2%的女性因晚期宫颈癌导致输尿管梗阻，而男性梗阻的主要原因是晚期膀胱癌。超声引导下的肾脏穿刺需要集合系统充分扩张才能成功且便于穿刺。最常见的并发症是血尿，所有患者的血尿均在24 - 48小时内顺利缓解。
PCN是临时缓解上尿路梗阻的一项重要且常见的操作。虽然荧光镜引导提供了更优的图像引导，但超声引导相对可靠，尽管学习曲线较长。充分的培训、谨慎的患者选择和耐心是成功的关键。
