Assessment Of Damage Of Porcine Solitary Kidney Caused By Percutaneous Nephrostomy: Standard Versus Mini-passage

Objective To assess and compare the effects of standard percutaneous nephrostomy (PCN) and minimally invasive percutaneous nephrostomy(MPCN) on renocortical damage of solitary kidney in pigMethods A solitary-kidney animal model was established by removing the left kidney in 12 female pigs,which were randomized to PCN and MPCN groups,an ultrasound guided PCN was done two weeks later.The tracts in PCN group were dilated to 24F with the Amplatz fascial dilator,and that in MPCN to 16F.Ureanitrogen,serum creatinine,kalium,natrium,chlorine,the combining power of carbon dioxide in serum (ECO₂) were detected,before and after surgery.Four weeks later,the pigs were sacrificed and the kidneys removed for macroscopic and histologic examination.The scar tissues surrounding the tracts were dissected,and Massion staining done,the area of scar was measured with digital image analysis,the volumes of scar and renal cortex were calculated.The volumes of scar and that accounting for the volume of renal cortex in percentage between the two groups were compared.Results A PCN model in pigs with solitary kidney was successfully set up.The above items detected,before and after surgery,showed no statistical difference between the two groups(P＞0.05).No significant difference was found in terms of gross and microscopic observation of the kidney.There was no statistical difference of scar volume (P＞0.05) and that ratio to total renal cortex volume(P＞0.05) between the two groups.Conclusion Both PCN and MPCN have a very little impact on renal function and renal cortex.MPCN has no obvious superiority over PCN in reducing parenchymal damage of solitary kidney.