MP15-03 NEPHROSTOMY TUBES PLACED PRIOR TO PERCUTANEOUS RENAL STONE SURGERY ARE PRACTICAL FOR OBTAINING ACCESS-- AN ANALYSIS OF THE UTILITY OF PRE-EXISTING NEPHROSTOMY TUBES AT A SINGLE INSTITUTION

Abstract

You have accessJournal of UrologyStone Disease: Surgical Therapy III (MP15)1 Apr 2020MP15-03 NEPHROSTOMY TUBES PLACED PRIOR TO PERCUTANEOUS RENAL STONE SURGERY ARE PRACTICAL FOR OBTAINING ACCESS-- AN ANALYSIS OF THE UTILITY OF PRE-EXISTING NEPHROSTOMY TUBES AT A SINGLE INSTITUTION Aaron Bradshaw*, Seth Bechis, Kaitlan Cobb, Dave Friedlander, and Roger Sur Aaron Bradshaw*Aaron Bradshaw* More articles by this author , Seth BechisSeth Bechis More articles by this author , Kaitlan CobbKaitlan Cobb More articles by this author , Dave FriedlanderDave Friedlander More articles by this author , and Roger SurRoger Sur More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000840.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Renal access in percutaneous nephrolithotomy may be obtained via a pre-existing nephrostomy tube (NT) tract; however, emergently placed NTs are not always ideal for subsequent surgery. We sought to compare the usability of emergently and non-emergently placed NTs. METHODS: A retrospective review was performed of UC San Diego subjects undergoing percutaneous renal surgery between January 2016 and October 2018. Demographics and peri-operative variables were collected. The primary outcome was the usability of NT tract for dilation and instrumentation and was a composite of “usable” and “partially usable” tracts. “Usable” indicated a tract in which PCNL could be completed without the need for additional tract creation; “partially usable” indicated a tract which was dilated and used but required at least one additional tract dilation, and “unusable” indicated the absence of tract dilation or usage. RESULTS: 65 PCNL cases had previously placed indwelling NT at time of percutaneous renal surgery (35 emergent, 30 non-emergent). Demographic and peri-operative data were similar. There was no significant difference between emergent vs. non-emergent groups in tract usability (emergent 51% vs. non-emergent 63% usable, difference in proportions 95% CI, -13% to 37%, p=0.34), location of NTs (p=0.29), or location of ultimate PCNL access (p=0.86). Total number of access tracts was greater in the cohort with unusable NT tracts (p<0.01). The need for subsequent upper pole access for completion of PCNL occurred in 57% of unusable NT tracts, 33% of partially usable NT tracts, and 6% of usable of NT tracts (p<0.01). There was no difference in stone location between those NT tracts deemed usable, partially usable, or unusable (p=0.40) CONCLUSIONS: Pre-existing NT, regardless of indication for placement, served as sufficient PCNL access tracts in over half of recorded cases. Contrary to recently published reports, the utility of pre-existing NT appears to vary among health systems. Other variables, including the desired location of PCNL appear to directly influence the likelihood of NT tract usability. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e204-e205 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Aaron Bradshaw* More articles by this author Seth Bechis More articles by this author Kaitlan Cobb More articles by this author Dave Friedlander More articles by this author Roger Sur More articles by this author Expand All Advertisement PDF downloadLoading ...