婴儿经皮肾造瘘术:20 年的单中心经验

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY
Accounts of Chemical Research Pub Date : 2024-09-09 Epub Date: 2023-08-18 DOI:10.4274/dir.2023.232276
Onur Taydaş, Emre Ünal, Devrim Akıncı, Mehmet Şeker, Osman Melih Topçuoğlu, Okan Akhan, Türkmen Turan Çiftçi
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引用次数: 0

摘要

目的:研究成像引导下经皮肾造瘘术(PCN)在婴儿中的安全性和有效性:这项回顾性研究共纳入了 75 名(50 名男孩;66.7%)在 20 年内接受过 PCN 手术的患者,他们的平均年龄为 121 天(范围为 1-351 天)。研究记录了每位患者的 PCN 适应症、导管尺寸、导管插入的平均时间、并发症以及肾造瘘术后进行的手术。技术成功与否取决于肾造口术导管是否成功置入肾盂阴道系统。临床成功的定义是肾积水完全消退以及随访期间肾功能检查有所改善。对于漏尿患者,技术和临床成功与否取决于漏尿是否得到缓解:结果:技术成功率为 100%,未观察到与手术相关的死亡率。有 11 名患者(14.7%)进行了双侧 PCN。PCN 最常见的适应症是输尿管盆腔交界处梗阻(41 例,54.7%)。两名患者出现了与手术相关的重大并发症(一名患者因局麻药导致高铁血红蛋白血症和呼吸停止,另一名患者因穿刺部位漏尿导致尿瘤)。轻度漏尿是唯一出现的轻微并发症,而且仅发生在一名患者身上。16名患者(21.3%)通过更换或翻修手术处理了导管相关并发症:结论:影像引导 PCN 是一种可行且有效的手术,技术成功率高,主要并发症发生率低,对保护婴儿肾功能很有帮助。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Percutaneous nephrostomy in infants: a 20-year single-center experience

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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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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