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percutaneous nephrostomy versus ureteral stent in hydronephrosis secondary to obstructive urolithiasis:A systematic review and meta-analysis

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Asian Journal of Urology 2024年第2期11卷 261-270页

作者： Andreia Cardoso Aparício Coutinho Gonçalo Neto Sara Anacleto Catarina Laranjo Tinoco Nuno Morais Mário Cerqueira-Alves Estevão Lima Paulo Mota Department of Urology Hospital de BragaBragaPortugal School of Medicine University of MinhoBragaPortugal Association(2CA-Braga).School of Medicine University of MinhoBragaPortugal

Objective: To assess if there is a preferable intervention between retrograde ureteral stent (RUS) and percutaneous nephrostomy (PCN) tube, in cases of upper urinary tract stone obstruction with complications requiring urgent drainage, by evaluating outcomes regarding urinary symptoms, quality of life (QoL), spontaneous stone passage, and length of hospital stays, since there is no literature stating the superiority of one modality over the ***: We searched MEDLINE and other sources for relevant articles in June 2019 without any date restrictions or filters applied. The selection was done first by the title and abstract screening and then by full-text assessment for eligibility. Only randomized controlled trials or cohort studies in patients with hydronephrosis secondary to obstructive urolithiasis that presented comparative data between PCN and RUS placement concerning at least one of the defined outcome measures were included. Lastly, MEDLINE database and PubMed platform were screened again using the same terms, from June 2019 until November ***: Of 556 initial articles, seven were included in this review. Most works were considered of moderate-to-high quality. Three studies regarding QoL showed a tendency against stenting, even though only one demonstrated statistically significant negative impact on overall health state. Two works reported significantly more post-intervention urinary symptoms in stenting patients. One article found that PCN is a significant predictor of spontaneous stone passage, when adjusted for stone size and location. Findings on length of hospital stays were not consistent among ***: PCN appears to be the intervention better tolerated, with less impact on the patient’s perceived QoL and less post-operative urinary symptoms, in comparison with RUS. Nevertheless, further studies with larger samples and a randomized controlled design are suggested.

关键词： Ureteral stent percutaneous nephrostomy Obstructive urolithiasis Urinary symptoms Quality of life

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Clinical Application of percutaneous nephrostomy in Some Urologic Diseases

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2008年第4期28卷 439-442页

作者：罗洪波刘修恒吴天鹏张孝斌 Department of Urology Renmin Hospital Wuhan University

percutaneous nephrostomy was applied in some other urologic diseases and the efficacy was evaluated. percutaneous nephrostomy for percutaneous nephrolithotomy （PNL） was performed in patients with various renal, perinephric and bladder diseases （n=79）. The tract establishment, operation duration and complications were observed and the efficacy was assessed. The results showed that the tracts were successfully established in 79 cases. The operation lasted 4–20 min. 12F–16F single tract was established in nephrohydrop patients and 16F–20F single or multiple tracts were established in patients with pyonephrosis, renal cortical abscess, renal cyst and perinephric abscess. During dilation, no leakage of liquor puris was noted. Establishment of 18F single tract was achieved in one urinoma patient. In two patients with foreign body in kidney, the foreign bodies were removed via established 14F single tract. 18F tracts were established in 2 patients with bladder contracture, which was followed by the placement of 16F balloon urethral catheter for drainage. No complications, such as massive bleeding, intestinal injury and spreading of infection took place in our series. All the patients were followed up for 2–12 months. No long-term complications such as dropping of drainage tube occurred. It is concluded that as a minimally invasive technique, percutaneous nephrostomy has the advantages of convenience, simplicity and causing less complications and can be used for various urologic diseases.

关键词： urologic disease percutaneous nephrostomy minimal invasive surgery

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Use of percutaneous nephrostomy and ureteral stenting in management of ureteral obstruction

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World Journal of Nephrology 2016年第2期5卷 172-181页

作者： Linda Hsu Hanhan Li Daniel Pucheril Moritz Hansen Raymond Littleton James Peabody Jesse Sammon Vattikuti Urology Institute Henry Ford Health System Center for Outcomes Research and Evaluation Maine Medical Center

The management options for ureteral obstruction are diverse, including retrograde ureteral stent insertion or antegrade nephrostomy placement, with or without eventual antegrade stent insertion. There is currently no consensus on the ideal treatment or treatment pathway for ureteral obstruction owing, in part, to the varied etiologies of obstruction and diversity of institutional practices. Additionally, different clinicians such as internists, urologists, oncologists and radiologists are often involved in the care of patients with ureteral obstruction and may have differing opinions concerning the best management strategy. The purpose of this manuscript was to review available literature that compares percutaneous nephrostomy placement vs ureteral stenting in the management of ureteral obstruction from both benign and malignant etiologies.

关键词： percutaneous nephrostomy Urinary diversion Ureteral obstruction Quality of life Ureteral stents Pelvic malignancy Urinary drainage

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Laparoscopic ureterolysis with simultaneous ureteroscopy and percutaneous nephroscopy for treating complex ureteral obstruction after failed endoscopic intervention:A technical report

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Asian Journal of Urology 2015年第4期2卷 238-243页

作者： Zhixiang Wang Bing Liu Xiaofeng Gao Yi Bao Yang Wang Huamao Ye Yinghao Sun Linhui Wang Department of Urology Changzheng HospitalSecond Military Medical UniversityShanghaiChina Department of Urology Changhai HospitalSecond Military Medical UniversityShanghaiChina

Objective:Complex ureteral obstruction is refractory to conventional urological *** report describes a case of laparoscopic ureterolysis with simultaneous ureteroscopy and percutaneous nephroscopy for treating complex ureteral ***:Right-side multiple ureteral stones and complicating ureteral obstruction failed an initial attempt of ureteroscopy lithotripsy with simultaneous percutaneous nephroscopy in a 23-year-old *** ureterolysis with ureteroscopy and percutaneous nephroscopy was used simultaneously to dissect the periureteral adhesions with the patient placed in the Galdakao-modified supine Valdivia *** ureter was incised to allow the insertion of a ureteral catheter through the twisted ureter,and a guide wire was advanced into the pelvis using ureteroscopy.A double-J stent was placed into the right-side ureter using antegrade percutaneous ***:The laparoendoscopic procedure lasted 330 min with an estimated bleeding volume of 100 *** patient underwent an uneventful postoperative course,and postoperative followup radiography confirmed good positioning of the double-J *** double-J stent was removed 3 months after *** patient remained asymptomatic within a 13-month follow-up ***:Laparoscopic ureterolysis with simultaneous ureteroscopy and percutaneous nephroscopy is an effective and safe treatment option for complex ureteral obstruction.

关键词： Ureteral obstruction Laparoscopic ureterolysis Ureteroscopy percutaneous nephrostomy

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Acute kidney injury due to bilateral malignant ureteral obstruction:Is there an optimal mode of drainage?

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World Journal of Nephrology 2022年第6期11卷 146-163页

作者： Rabea Ahmed Gadelkareem Ahmed Mahmoud Abdelraouf Ahmed Mohammed El-Taher Abdelfattah Ibrahim Ahmed Department of Urology Assiut Urology and Nephrology HospitalFaculty of MedicineAssiut UniversityAssiut 71515AssiutEgypt

There is a well-known relationship between malignancy and impairment of kidney functions,either in the form of acute kidney injury or chronic kidney *** the former,however,bilateral malignant ureteral obstruction is a surgically correctable factor of this complex *** warrants urgent drainage of the kidneys in emergency ***,there are multiple controversies and debates about the optimal mode of drainage of the bilaterally obstructed kidneys in these *** review addressed most of the concerns and provided a comprehensive presentation of this topic from the recent ***,we provided different perspectives on the management of the bilateral obstructed kidneys due to *** the frequent trials for improving the success rates and functions of ureteral stents,placement of a percutaneous nephrostomy tube remains the most recommended tool of drainage due to bilateral ureteral obstruction,especially in patients with advanced ***,the disturbance of the quality of life of those patients remains a major unresolved *** the unfavorable prognostic potential of the underlying malignancy and the various risk stratification models that have been proposed,the response of the kidney to initial drainage can be anticipated and evaluated by multiple renal prognostic factors,including increased urine output,serum creatinine trajectory,and time-to-nadir serum creatinine after drainage.

关键词： Acute kidney injury Kidney Malignancy percutaneous nephrostomy Ureteral obstruction Ureter

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Estimation of successful capping with complete aspiration of bladder via nephroureterostomy tube

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World Journal of Clinical Urology 2020年第1期9卷 1-8页

作者： Majid Maybody Wesley K Shay Deborah A Fleischer Meier Hsu Chaya Moskowitz Department of Radiology Interventional Radiology ServiceMemorial Sloan Kettering Cancer CenterNew YorkNY 10065United States Department of Biostatistics and Epidemiology Memorial Sloan Kettering Cancer CenterNew YorkNY 10065United States

BACKGROUND Ureteral stent and nephroureterostomy tube(NUT)are treatments of ureteral *** stent provides better quality of *** of NUT is desired whenever *** To assess outcomes of capping trial among cancer patients with complete aspiration of retained contrast from bladder via *** Our Institutional Review Board approved retrospective review of all NUT placement,NUT exchange and conversion of nephrostomy catheter into NUT performed during June 2013 to June 2015(n=578).Cases were excluded due to lack of imaging of bladder(n=37),incomplete aspiration of bladder(n=324),no attempt at capping NUT(n=166),and patients with confounding factors interfering with results of capping trial including non-compliant bladder,bladder outlet obstruction and catheter malposition(n=14).Study group consisted of 37 procedures in 34 patients(male 19,female 15,age 2-83 years,average 58,median 61)most with cancer(prostate 8,endometrial 5,bladder 4,colorectal 4,breast 2,gastric 2,neuroblastoma 2,cervical 1,ovarian 1,renal 1,sarcoma 1,urothelial 1 and testicular 1)and one with Crohn’s *** records were reviewed to assess outcomes of capping *** 95%confidence intervals(95%CI)were *** Among patients with complete aspiration of retained contrast,30(81%,95%CI:0.65-0.92)catheters were successfully capped(range 12-94 d,average 40,median 24.5)until planned conversion to internal stent(23),routine exchange(5),removal(1)or death unrelated to catheter(1).Seven capping trials(19%,95%CI:0.08-0.35)were unsuccessful(range 2-22 d,average 12,median 10)due to leakage(3),elevated creatinine(2),fever/hematuria(1)and nausea/vomiting(1).CONCLUSION Capping trial success among patients with complete aspiration of retained contrast/urine from bladder via NUT appears high.

关键词： Nephroureterostomy tube Ureteral stent Capping trial Internalization Conversion percutaneous nephrostomy

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