Percutaneous nephrostomy insertion: outcome data from a prospective multi-operator study at a UK training centre

Abstract

The paper by Wah et al. 1. Wah TM, Weston MJ, Irving HC. Percutaneous nephrostomy insertion: outcome data from a prospective multi-operator study at a UK training centre. Clin Radiol 2004;59:255–61. Google Scholar is one of the few prospective studies of complications after percutaneous nephrostomy (PCN). With the contemporary concerns about service provision, it is timely. What are its messages? First, the performance figures broadly agree with the only existing guidelines: the American College of Radiology 2. ACR practice guidelines for the performance of percutaneous nephrostomy. In: ACR practice guidelines and technical standards. American College of Radiologists Reston, VA, 2003: 335–343 (www.acr.org, accessed September 2003). Google Scholar and the Society of Cardiovascular and Interventional Radiologists. 3. Ramchandani P. Cardella J.F. Grassi C.J. et al. Quality improvement guidelines for percutaneous nephrostomy. J Vasc Interv Radiol. 2001; 12: 1247-1251 Abstract Full Text Full Text PDF PubMed Scopus (50) Google Scholar This was the primary aim of the study, and the safety of PCN performed by a well-staffed unit is proven. These are reassuring data. The secondary study aims are less convincingly answered, given the smaller numbers in the sub-groups. For example, the number of cases requiring more than one needle pass is not statistically different when the consultants are compared with the trainees; and neither are the complication rates in the four groups (Table 1), including major events. In fact, of the operator-dependent figures only the technical success rate is significantly better for consultants.