Us vs Fluoroscopic Guided Renal Access

Study Overview
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Brief Summary
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this present study is to compare the result of fluoroscopy, ultrasonography (US) in the guidance of percutaneous nephrostomy pcn .

Detailed Description
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investigators will enroll 100 patients who are candidates for PCN in the study. By simple random sampling technique, patients will be assigned to two patient groups (group 1, US-guided approach , group 2, fluoroscopy-guided approach.The end point of the study is the comparison of outcome of procedure including stone free rate, transfusion rate, operation time, access time, length of stay and complications.

Official Title
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Ultrasonography Versus Fluoroscopic Guided Renal Access

Conditions
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Hydronephrosis

Intervention / Treatment
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* Procedure: Renal puncture


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: infected hydronephrotic kidney onen's grade 2-3 obstructed good cortex with backpressure changes onen's grade 2-3 . Evaluation of function of asymptomatic hydronephrotic kidney thin cortex onen's grade 4 Exclusion Criteria: congenital anomalies of kidney patient underwent transplant or urinary diversion solitary kidney

Ages Eligible for Study
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Minimum Age: 6 Years
Maximum Age: 90 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Ultrasonographic guided renal access<br>The use of ultrasound to make a puncture in kidney for pcn for drainage or evaluation of function or for shunt of urine | Procedure: Renal puncture<br>* The use of a needle for entering pelvicalyceal system of the kidney and put a guide wire for further pcn<br>|
| Experimental: Fluoroscopic guided renal access<br>The use of fluoroscopy to make a puncture in kidney for pcn for drainage or evaluation of function or for shunt of urine | Procedure: Renal puncture<br>* The use of a needle for entering pelvicalyceal system of the kidney and put a guide wire for further pcn<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Duration of puncture | The time taken for make a puncture | Within the operation | 
| duration of operation | time taken from patient putted on table until end of operation | withen the operation | 
| Rate of success | the rate success of intervention by u/s or by fluoroscopy | withen the operation | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| rate of Perioperative complication | numbers of patients with Adverse effects occures intra operative ,bleeding ,extravasation | withen the operation | 
| Haemoglobin concentration change | Compare preoperative and post operative Hg concentration | 24 hours post procedure |