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Ultrasound Guided Direct Percutaneous Nephrostomy (PCN) Tube Placement: Stepwise Report of a New Technique with Its
Bijit Lodh1, Sandeep Gupta1, Akoijam Kaku Singh2
1Postdoctoral (M.Ch. Trainee), Registrar, Department of Urology, Regional Institute of Medical Sciences (RIMS) , Imphal, Manipur, India .
Aims:
Ultrasound guided Percutaneous Nephrostomy (PCN) tube placement: evaluation, safety and efficacy review.
Settings And Design:
This was a quasi-experimental study conducted at Department of Urology, Regional Institute of Medical Sciences, Imphal.
Materials And Methods:
The total number of 176 patients with grade I-IV hydronephrosis requiring PCN tube placement were included in the study. Scientific, operational and accessory steps of the technique and its related safety and efficacy pre-procedural, intra-procedural and post-procedural parameters were carefully and meticulously recorded.
Statistical Analysis:
Statistical analyses was performed using the Statistical Package for the Social Sciences (SPSS 16.0) for Windows.
Results:
The average length of the procedure was 9.07±2.79 (6-15) minutes. Severe procedure related pain (VAS score 8-10) was observed only in 18 patients (10.23%). Nephrostomy tube placement was successful in 96.60% of cases and only 9.66% required more than a single attempt of puncture. In this study, impacted ureteric calculus was found to be most common indication of PCN tube placement.
Conclusions:
Ultrasound guided direct PCN tube placement is a reliable, easy and cost effective technique. This procedure is particularly suitable for developing countries like India, where the majority of the patients belongs to the low socio-economical status and health care system lacks adequate infrastructural facility at most places.
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