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The Role of Percutaneous Nephrostomy for Uretric Obstruction due to Advanced Abdominopelvic Malignancy: A Retrospective Analysis

Author(s): Rida Mansoor, Muhammad Faisal, Shahan Raza, Hannan Ali, Osama Shakeel, Zaeem Shahid, Haroon Hafiz

Introduction: In advanced or metastatic abdominopelvic malignancy, ureteric obstruction is a known complication. (PCN) is a diversion procedure for decompression in order to improve renal function. It is debatable whether PCN is an effective management to relieve ureteric obstruction in a stage IV abdominoperineal disease. The aim of the study is to determine the outcome of PCN tube insertion in a palliative care setting.

Methodology: The study was conducted at Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore (SKMCH&RC). Data was retrieved from the electronic Hospital Information System (HIS) of the hospital. Duration of the study was from January, 2018 to December, 2020. We included patients who underwent percutaneous nephrostomy under palliative setting.

Results: A total of 111 patients were included in the study. The median age at the time of nephrostomy was 4915.6 years. 67 patients (60.4%) were males, while 44 patients (39.6%) were females. Pre procedural median level of creatinine were was 3.3±3.36. Unilateral nephrostomy was performed in 71 patient (63.9%), while 40 patients (36.1%) underwent bilateral nephrostomy. Post-procedural mean creatinine level were 2.52 + 2.80. Relief of symptoms was observed among 68 patients (62.2%). 75 patients (67.6%) did not develop any complications after the procedure. The two most common complications of the procedure in our study were dislodgement (9%) and infection (9%).

Conclusion: PCN is good for symptomatic and biochemical relief even in stage IV cancer, however due to increased incidence of complications in these patients the benefits might outweigh the risks.

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