Investig Clin Urol.  2019 Jan;60(1):29-34. 10.4111/icu.2019.60.1.29.

Is emergency percutaneous antegrade drainage of the upper urinary tract useful for future percutaneous nephrolithotomy access?

• Sabler IM
• Katafigiotis I
• Sfoungaristos S
• Lorber A
• Leotsakos
• Yutkin V
• Hidas G
• Gofrit ON
• Duvdevani

• KMID: 2434622
• DOI: http://doi.org/10.4111/icu.2019.60.1.29

Abstract

PURPOSE
To compare percutaneous nephrolithotomy (PCNL) operations between patients with a preoperative nephrostomy tube and patients that the renal access was obtained at the time of the surgery.
MATERIALS AND METHODS
We retrospectively evaluated PCNL cases. Patients were divided into two groups. Group 1 - a non-nephrostomy tube (percutaneous nephrostomy, PCN) group and Group 2 - patients with a PCN placed before the procedure. All preoperatively placed PCN's were performed in emergency situations by interventional radiologists (IR). Complications were classified according to the Clavien-Dindo classification. We compared stone characteristics, operation time, complications, efficacy and PCN usability at surgery.
RESULTS
Five hundred twenty-seven patients who were submitted to PCNL for renal stones were included in the study. In 73 patients (13.9%) the PCNs were placed before the surgery. Patients and stone characteristics, mean operative time (p=0.830), complications (p=0.859) and stone-free rates (93.0%) were similar between the groups. There was a trend toward higher complication rates in Group 1, but the difference was not statistically significant. Only 21 (29.0%) of preoperatively placed PCNs were used during PCNL for establishing a tract. The reasons for not using PCN tract were: pelvic or infundibular insertion (30.0%) and suboptimal anatomic location (70.0%).
CONCLUSIONS
Preoperative emergency inserted PCNs by IR usage rates were low during PCNL. Its placement neither affects the incidence of complications nor affects the operation time and outcomes. As such, when emergency renal drainage is indicated, the need for a future definitive PCNL should not influence the decision about the modality of renal drainage.

Keyword

Nephrostomy; Percutaneous nephrolithotomy; Renal lithiasis; Urolithiasis

MeSH Terms

Classification
Drainage*
Emergencies*
Humans
Incidence
Nephrostomy, Percutaneous*
Operative Time
Pregnenolone Carbonitrile
Retrospective Studies
Urinary Tract*
Urolithiasis
Pregnenolone Carbonitrile

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