Abeer Zafar, Muhammad Nawaz Anjum, Nabeel Shafi, Mehreen Fatima.
Role of Ultrasound Guided Percutaneous Nephrostomy in Obstructive Uropathy patients: Asystematic Literature Review.
Esculapio J Services Inst Med Sci Jan ;17(2):201-7.

Objectives: 1. To conduct a systemic review on USG guided PCN in obstructive uropathy and review its efficacy and complication rate. 2. To conduct a systemic review of USG guided PCN and establish qol in patients with obstructive uropathy. 3. To conduct a systemic review of USG guided PCN and examine its success rate. Methods: The materials and methods comprised of an extensive internet based article hunting with keywords of "Ultrasound(USG) guided PCN", "Obstructive uropathy", "Deranged renal function tests" and "Quality of life". The main medical websites/databases which were implored for this systemic review included PubMed, Cochrane review database, Research gate, Emedicine, EBSCO`s, medScape, Science Direct, Google, PMC articles and multitude of scientific publications in international journals from 1945 to March 2020. A total of 146 articles were selected, out of them, 9 articles fulfilled final scrutiny and were reviewed for this study. All studies involving blockade of ureters by any pathology, benign or otherwise, were included. USG was primary interventional tool in all studies. Results: Nine articles fulfilled all the pre-requisites for systemic analysis. The total data consisted of 630 people, having a mean age of 56 years (Variance: 3 - 70). Percutaneous nephrostomy catheter was placed to relieve blockade in both benign and malignant conditions. In 506 patients, one side was operated, while in 104 both sides were successfully attempted. There was attempted failure in placement of nephrostomy in remaining 20 cases. Out of 630, post-operative renal function improvement was shown in 575 patients, 55 patients showed no improvement. Overall a very negligible percentage of complications were reported in all studies (1-3%). The average stay in health care establishments was 14 days varying from 7 to 21 days. Conclusions: PCN is a safe and effective urinary diversion. It gives prompt relief to obstructive uropathy in critically ill patients. PCN is useful therapeutic procedure for benign and malignant ureteric obstruction while helping in preserving renal function, with a low complication rate. Ultrasound guided PCN is safe in Obstructive uropathy patients. Due to no need of general anesthesia, a very negligible failure rate < 2 % and very low complication rate of 1-3%, ultrasound guided nephrostomy tube placement is safe and highly effective in emergency decompression of kidneys.

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