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Emergency percutaneous nephrostomy: results and complications
1Department of Radiology, Long Island Jewish Medical Center, Albert Einstein College of Medicine, New Hyde Park, NY 11042.
Purpose:
Percutaneous nephrostomy is a well-established standardized procedure in the management of patients with various urologic problems. The goal of this study was to evaluate the effectiveness and safety of percutaneous nephrostomy in an emergency setting.
Patients And Methods:
Emergency percutaneous nephrostomy was performed in 160 patients with ages ranging from 2 to 89 years (mean, 52 years). Access to the kidney was planned and achieved with C-arm fluoroscopic guidance.
Results:
The initial technical success rate was 98%. Overall complication rate was 34%; 6% were major and 28% were minor. Major procedure-related complications, including sepsis, occurred in 6% of patients. Hematuria requiring transfusion was noted in 2.4% of patients. Minor complications included catheter displacement or malposition (4.8%), pelvic perforation (4.3%), paralytic ileus (2.4%), pneumonia/atelectasis (1.8%), and pleural effusion (1.2%). High-risk patients included those with diabetes, hypertension, and obesity. No deaths or significant morbidity resulted from any complication.
Conclusions:
Emergency percutaneous nephrostomy under fluoroscopic guidance is a simple, safe, and effective procedure and should be offered in all suitably equipped radiology departments.