The use of endoluminal ultrasonography for preventing significant bleeding during endopyelotomy: evaluation of helical computed tomography vs endoluminal ultrasonography for detecting crossing vessels

BJU International
Ad J M HendrikxStavros Gravas

Abstract

To evaluate, in a prospective study, the efficiency of helical computed tomography (CT) and endoluminal ultrasonography (ELUS) for detecting significant crossing vessels, a major cause of bleeding complications when treating patients with pelvi-ureteric junction (PUJ) obstruction, and to compare our results using ELUS with those of an earlier multicentre study (not using ELUS), to see whether the complication rate decreased. The study included 27 patients with a PUJ who had isotope renography, intravenous urography, helical CT and ELUS before surgery. Depending on the findings of ELUS, patients were treated with a pure lateral Acucise incision (Applied Medical, Irvine, CA, USA) an Acucise with changed cutting direction, or (later) a laparoscopic pyeloplasty. ELUS detected 15% more crossing vessels than helical CT; 16 patients had Acucise (seven lateral, nine other cutting direction), eight were treated with a laparoscopic pyeloplasty and three with other procedures. By contrast with earlier reports and as a consequence of using ELUS, there was no bleeding, vs 16% in the study not using ELUS. The success rate of 73% of the endourological approach is comparable with previous reports. ELUS is more sensitive in detecting relevant c...Continue Reading

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Citations

Sep 23, 2008·AJR. American Journal of Roentgenology·Ling LinJi-Bin Liu
Jan 17, 2014·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Ramit LambaChandana G Lall
Jun 20, 2008·International Journal of Urology : Official Journal of the Japanese Urological Association·Osamu UkimuraTsuneharu Miki

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