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Percutaneous nephrostomy in infants: a 20-year single-center experience
Onur Taydaş1, Emre Ünal2, Devrim Akıncı2
1Sakarya University Faculty of Medicine, Department of Radiology, Sakarya, Türkiye
Insights
Imaging-guided percutaneous nephrostomy (PCN) is safe and effective in infants, demonstrating 100% technical success and low complication rates. This procedure is valuable for preserving kidney function in pediatric patients.
Area of Science:
- Pediatric Urology
- Interventional Radiology
- Nephrology
Background:
- Infantile kidney obstruction requires effective management.
- Percutaneous nephrostomy (PCN) is a minimally invasive option.
- Assessing the safety and efficacy of imaging-guided PCN in infants is crucial.
Purpose of the Study:
- To evaluate the safety and efficacy of imaging-guided percutaneous nephrostomy (PCN) in infants.
- To determine technical and clinical success rates.
- To identify complication rates associated with the procedure.
Main Methods:
- Retrospective study of 75 infants undergoing imaging-guided PCN over 20 years.
- Data collected included indications, catheter size, duration, complications, and outcomes.
- Technical success defined by successful catheter placement; clinical success by hydronephrosis resolution and improved renal function.
Main Results:
- 100% technical success rate with no procedure-related mortality.
- Ureteropelvic junction obstruction was the most common indication (54.7%).
- Two major complications (1 methemoglobinemia/respiratory arrest, 1 urinoma) and one minor complication (urinary leakage) were reported.
Conclusions:
- Imaging-guided PCN is a feasible and effective procedure for infants.
- The technique offers high technical success and a low rate of major complications.
- PCN is beneficial for protecting kidney function in the pediatric population.
Purpose:
To investigate the safety and efficacy of the imaging-guided percutaneous nephrostomy (PCN) procedure in infants.
Methods:
A total of 75 (50 boys; 66.7%) patients with a mean age of 121 days (range, 1-351 days) who underwent PCN over a period of 20 years were included in this retrospective study. For each patient, PCN indications, catheter size, the mean duration of catheterization, complications, and the procedure performed following nephrostomy were recorded. Technical success was determined based on the successful placement of the nephrostomy catheter within the pelvicalyceal system. Clinical success was defined as the complete resolution of hydronephrosis and improvement in renal function tests during follow-up. In patients with urinary leakage, technical and clinical success was determined based on the resolution of leakage.
Results:
The technical success rate was 100%, and no procedure-related mortality was observed. In 11 patients (14.7%), bilateral PCN was performed. The most frequent indication of PCN was ureteropelvic junction obstruction (n = 41, 54.7%). Procedure-related major complications were encountered in two patients (methemoglobinemia and respiratory arrest caused by the local anesthetic agent in one patient and the development of urinoma caused by urinary leakage from the puncture site in the other). Mild urinary leakage was the only minor complication that occurred and only in one patient. Catheter-related complications were managed through replacement or revision surgery in 16 patients (21.3%).
Conclusion:
Imaging-guided PCN is a feasible and effective procedure with high technical success and low major complication rates, and it is useful for protecting kidney function in infants.
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