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TRANSCATHETER ETHANOL RENAL ABLATION IN 20 PATIENTS WITH PERSISTENT URINE LEAKS: AN ALTERNATIVE TO SURGICAL NEPHRECTOMY

2000; Lippincott Williams & Wilkins; Volume: 164; Issue: 4 Linguagem: Inglês

10.1016/s0022-5347(05)67130-3

1527-3792

Thierry de Baère, C. Lagrange, Viseth Kuoch, Philippe Morice, B Court, Alain Roche,

Kidney Stones and Urolithiasis Treatments

No AccessJournal of UrologyOriginal Articles1 Oct 2000TRANSCATHETER ETHANOL RENAL ABLATION IN 20 PATIENTS WITH PERSISTENT URINE LEAKS: AN ALTERNATIVE TO SURGICAL NEPHRECTOMY THIERRY DE BAERE, CHRISTINE LAGRANGE, VISETH KUOCH, PHILIPPE MORICE, BERNARD COURT, and ALAIN ROCHE THIERRY DE BAERETHIERRY DE BAERE More articles by this author , CHRISTINE LAGRANGECHRISTINE LAGRANGE More articles by this author , VISETH KUOCHVISETH KUOCH More articles by this author , PHILIPPE MORICEPHILIPPE MORICE More articles by this author , BERNARD COURTBERNARD COURT More articles by this author , and ALAIN ROCHEALAIN ROCHE More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)67130-3AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We evaluate the efficacy of transcatheter ethanol renal ablation for destruction of a unilateral, poorly functioning kidney with persistent urinary leaks from fistulas or a nephrostomy tube. Materials and Methods: From January 1992 to January 1999, 19 females and 1 male with a history of pelvic neoplasms, which were responsible for ureteral leaks through the nephrostomy tube in 13 cases or fistulas in 7, were treated with transcatheter ethanol renal ablation. Serum creatinine ranged from 60 to 140 μmol./l. (mean 90), and function of the involved kidney determined by diethylenetetraminepentaacetic acid scintigraphy in 16 patients or by morphological imaging in 4 was low. Drainage of the renal cavities and antibiotic therapy preceded renal ablation. After epidural anesthesia or intravenous sedation renal ablation was performed by catheterization of the renal artery and injection of 1.5 to 12 ml. (mean 4.6) absolute ethanol, and completed by proximal occlusion with coils and absorbable gelatin sponge. Results: Arterial flow was interrupted in all cases. Urinary flow ceased in 2 days in 18 of 20 patients, and drains were removed. Two patients had residual urine that was successfully treated with additional embolization. No complications occurred. Conclusions: Transcatheter ethanol renal ablation is safe and effective, and permits an in situ nephrectomy that can replace surgical nephrectomy for treatment of urinary leaks. References 1 : Obstetric and gynaecological ureteric injuries: treatment and results. Br J Urol1996; 77: 21. Google Scholar 2 : Internal urinary diversion in pelvic cancers and quality of life. Value of double “J” endoprosthesis. J Urol (Paris)1995; 101: 221. Google Scholar 3 : Complications of laparoscopic nephrectomy in 185 patients: a multi-institutional review. J Urol1995; 154: 479. Link, Google Scholar 4 : Instant selective arterial occlusion with isobutyl-2-cyanocrylate. Radiology1975; 114: 227. Google Scholar 5 : Ablation of renal tumors with absolute ethanol: a new technique. Radiology1981; 141: 619. Google Scholar 6 : Renal tumor infarction with absolute ethanol. 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Google Scholar From the Departments of Interventional Radiology and Urology, Institut Gustave Roussy, Villejuif Cedex, France© 2000 by American Urological Association, Inc.FiguresReferencesRelatedDetails Volume 164Issue 4October 2000Page: 1148-1152 Advertisement Copyright & Permissions© 2000 by American Urological Association, Inc.Keywordsrenal arteryiodized oiltherapeuticsethanolpelvic neoplasmsMetrics Author Information THIERRY DE BAERE More articles by this author CHRISTINE LAGRANGE More articles by this author VISETH KUOCH More articles by this author PHILIPPE MORICE More articles by this author BERNARD COURT More articles by this author ALAIN ROCHE More articles by this author Expand All Advertisement PDF downloadLoading ...