Clinical application of CT-guided mini-percutaneous nephrostomy external drainage

Objective: To investigate the clinical value of CT-guided mini-percutaneous nephrostomy (m-PCN) external drainage in treating obstructive hydronephrosis and pyonephrosis in patients who were in a complex and critical condition. Methods: CT-guided m-PCN was carried out in 24 patients with hydronephrosis and pyonephrosis who were in a complex and critical condition. An 8F pig tail drainage tube was placed in the renal pelvis. The further therapeutic measure, i.e. second-stage surgery or durative drainage, was decided by the renal function and patient's clinical condition. The technical results and the clinical data were retrospectively analyzed. Results: Technical success of m-PCN external drainage with single procedure was obtained in a total of 29 obstructed renal pelvis of 24 patients. The obstruction was immediately relieved, and the external drain was kept to be patent. The clinical results were satisfactory. The complications included transient hematuria (n = 3) and pyrexia (n = 3). No severe complications occurred. The nephrostomy catheter was continuously reserved in two cases. Conclusion: CT-guided mini-percutaneous nephrostomy is a safe, effective and highly-repeatable minimally-invasive treatment for obstructive hydronephrosis and pyonephrosis with less complication. It is especially valuable for weak patients who are in a complex and critical condition as well as for the manipulation of the second-stage surgery if it is scheduled. Therefore, CT-guided mini-percutaneous nephrostomy external drainage is of great value in clinical practice. (authors)