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CT-guided nephrostomy-An expedient tool for complex clinical scenarios
Maximilian Peter Brandt1, Thomas Lehnert2, Theresa Czilwik3
1Department of Urology and Pediatric Urology, Mainz University Medical Center, Langenbeckstraße 1, 55131 Mainz, Germany.
European Journal of Radiology
|January 3, 2019
Summary
CT-guided percutaneous nephrostomy (PCN) is a safe and effective minimally-invasive procedure for treating urinary tract obstructions, especially in complex cases like obese patients or non-dilated kidneys. This technique demonstrates low complication rates and is valuable for managing urinary leaks and fistulas.
Area of Science:
- Urology
- Interventional Radiology
- Nephrology
Background:
- Percutaneous nephrostomy (PCN) is crucial for managing obstructed urinary tracts.
- Ultrasound and fluoroscopy have limitations in obese patients, non-dilated uropathy, and risk contrast-related complications.
- CT-guided PCN offers an alternative to overcome these limitations.
Purpose of the Study:
- To present the experience of a tertiary referral center with CT-guided PCN.
- To evaluate the feasibility, success rates, and complications of CT-guided PCN.
Main Methods:
- Retrospective analysis of 140 CT-guided PCN procedures in 77 patients (Oct 2003-Oct 2013).
- Data collected included patient demographics, indications, procedural parameters, success rates, complications, and mortality.
- Statistical analysis of radiological aspects, technical/therapeutic success, and complications.
Main Results:
- 90% technical success rate with a low complication rate (3.6% minor B).
- Effective in treating obstructive uropathy (62.9%), urine extravasation (22.9%), and fistulas (11.4%).
- Successful in non-dilated kidneys (56.4%) and obese patients (BMI 27).
Conclusions:
- CT-guided PCN is a feasible approach with low morbidity.
- Particularly beneficial for complex cases: critically ill, obese, post-operative patients, and non-dilated kidneys.
- A minimally-invasive option for urinary tract leakages and fistulas.
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