Goel Ritesh, Nayak Brusabhanu, Singh Prabhjot, Gamanagatti Shivanand, Yadav Richa
Department of Urology, All India Institute of Medical Sciences, New Delhi, India.
Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India.
J Endourol Case Rep. 2020 Dec 29;6(4):472-475. doi: 10.1089/cren.2020.0151. eCollection 2020.
Localized urinary extravasation is a known complication after partial nephrectomy; however, rarely it forms a nephrocutaneous fistula. Nephrocutaneous fistula after partial nephrectomy is a management challenge for the treating surgeon. It is typically managed with indwelling ureteral stent placement. Persistent fistula after indwelling ureteral stent can be managed with percutaneous nephrostomy drainage. However, persistence after all these measures is a real therapeutic dilemma. Few reports are available on effective management of persistent urine leak by percutaneous obliteration of leak site using glue. We report one such rare case of persistent nephrocutaneous fistula in a 41-year-old man of Indo-Aryan ethnicity. He was managed effectively with percutaneous cyanoacrylate glue application, when all the conservative methods failed. At 6 months follow-up he is doing well clinically and radiologically. Persistent nephrocutaneous fistula after partial nephrectomy is a rare and highly morbid condition, which leads to multiple intervention and prolonged hospital stay. Percutaneous glue application is a potential therapeutic approach to tackle such cases with good results.
局限性尿外渗是部分肾切除术后已知的并发症；然而，它很少形成肾皮肤瘘。部分肾切除术后的肾皮肤瘘对治疗外科医生来说是一个管理挑战。通常通过留置输尿管支架来处理。留置输尿管支架后持续存在的瘘可通过经皮肾造瘘引流来处理。然而，在采取所有这些措施后仍持续存在是一个真正的治疗难题。关于使用胶水经皮闭塞渗漏部位有效处理持续性尿漏的报道很少。我们报告了一例这样罕见的持续性肾皮肤瘘病例，患者为一名41岁的印度 - 雅利安族男性。当所有保守方法均失败时，通过经皮应用氰基丙烯酸酯胶水对其进行了有效治疗。在6个月的随访中，他在临床和影像学方面情况良好。部分肾切除术后持续性肾皮肤瘘是一种罕见且病态严重的情况，会导致多次干预和延长住院时间。经皮应用胶水是处理此类病例的一种有潜力的治疗方法，效果良好。
