ULTRASONICALLY-GUIDED PERCUTANEOUS NEPHROSTOMY IN HYDRONEPHROSIS: REPORT OF 2 CASES

Abstract

Modern advancement in ultrasonographic technology permits wide implementation of ulrasonographically guided percutaneous nephrostomy as an urgent medical treatment for acute renal failure causec by various sorts of advanced malignant cancer. Recently, we had the opportunity to perform two percutaneous nephropyelostomies in patients with acute hydronephrosis and obtained satisfactory clinical results which we report hereed. We used a GC-10A linear electronic transducer for aspiration biopsy with an SAL-50A (TOSHIBA Medical Corporation) . The nephropyelostomy tube, designed by us and made by HAKKO Co., was a 20 cm long 8F size silicon balloon catheter, and we used an 8.5F size PTCD set, also by HAKKO Co. Both patients had distal ureteral obstructions caused by the advanced malignant cancer and were thought to have poor surgical indication, or not at all. Case 1: A sixty-two-year-old man was admitted because of anuria and lumbago suspected to be caused by renal failure occurring after being radical operated on for gastric cancer a year and a half previous. Case 2 : A fifty-two-year-old man was admitted because of anuria, pain and tenderness over the right flank probably caused by renal failure failure occurring after being radical operated on for rectum cancer eight months previous. After percutaneous nephrostomies, there were marked improvements in their clinical conditions, and no conspicuous complications. In this method, compared to those so far, 8F silicon balloon catheter is inserted into the pelvis without the use of a guide wire, and its chronic use seems to be possible. In view of the inaccuracy of other methods of assessment, we consider percutaneous nephrostomy using a balloon catheter to be the most accurate, predictive method available today.