Establishment of a Percutaneous Nephrostomy Service to Treat Obstructive Uropathy Secondary to Cervical Cancer in Tanzania
Background Cervical cancer is the fourth most common cancer among women globally. Age-standardized cervical cancer mortality is higher in East Africa than anywhere else in the world. Prior to October 2018, patients presenting with obstructive uropathy secondary to late-stage cervical cancer in Tanza...
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| Format: | Article |
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Wolters Kluwer Medknow Publications
2022-01-01
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| Series: | The Arab Journal of Interventional Radiology |
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| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0042-1744507 |
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| author | Ivan Rukundo Erick M. Mbuguje Azza Naif Manish Patel Fabian Laage-Gaupp Murray Asch Vijay Ramalingam |
| author_facet | Ivan Rukundo Erick M. Mbuguje Azza Naif Manish Patel Fabian Laage-Gaupp Murray Asch Vijay Ramalingam |
| author_sort | Ivan Rukundo |
| collection | DOAJ |
| description | Background Cervical cancer is the fourth most common cancer among women globally. Age-standardized cervical cancer mortality is higher in East Africa than anywhere else in the world. Prior to October 2018, patients presenting with obstructive uropathy secondary to late-stage cervical cancer in Tanzania who were no longer eligible for palliative chemoradiation therapy were discharged home without intervention. The purpose of this study was to evaluate whether the establishment of a percutaneous nephrostomy service in a quaternary hospital in Dar es Salaam, Tanzania, a resource-limited country, benefits patients who have late-stage cancer induced obstructive uropathy.
Materials and Methods A retrospective study was performed on patients who presented with obstructive uropathy secondary to late-stage cervical cancer and have undergone percutaneous nephrostomy at Muhimbili National Hospital and Ocean Road Cancer Institute from October 2018 to May 2021. Twenty-one interventional radiology (IR) teaching teams consisting of IR attendings, IR technologists, and nurses travelled to Tanzania from North America on monthly 2-week trips during that period. A review of preprocedural, procedural, and follow-up data was performed using Research Electronic Data Capture. Statistical analysis and comparison were performed on patients' creatinine levels preprocedure, 7 days and 30 days postprocedure.
Results Sixty-two patients qualified to be included in this study. In addition to the initial 62 nephrostomy placements, 14 follow-up procedures were performed either under visiting faculty supervision or independently by the Tanzanian IR fellows. Technical success rate was 98.7%. Complications (SIR Class A and B) occurred in eight cases. The average preprocedure creatinine (1051.48 ± 704.08µmol/L) decreased by 59% 7 days postprocedure and by 77% 30 days postintervention. Postprocedural clinical information was obtained for 28 (45.2%) patients and 18 were able to restart chemotherapy following nephrostomy.
Conclusion Prior to 2018, percutaneous nephrostomy placement was not available in Tanzania. This study presented the initial safety, technical feasibility, and clinical benefit of establishing a percutaneous nephrostomy service in such a resource-limited setting. |
| format | Article |
| id | doaj-art-2b87530446e04d50b38ee63f98908a3f |
| institution | DOAJ |
| issn | 2542-7075 2542-7083 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | The Arab Journal of Interventional Radiology |
| spelling | doaj-art-2b87530446e04d50b38ee63f98908a3f2025-08-20T03:15:39ZengWolters Kluwer Medknow PublicationsThe Arab Journal of Interventional Radiology2542-70752542-70832022-01-01060103303610.1055/s-0042-1744507Establishment of a Percutaneous Nephrostomy Service to Treat Obstructive Uropathy Secondary to Cervical Cancer in TanzaniaIvan Rukundo0Erick M. Mbuguje1Azza Naif2Manish Patel3Fabian Laage-Gaupp4Murray Asch5Vijay Ramalingam6Department of Radiology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, TanzaniaDepartment of Radiology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, TanzaniaDepartment of Radiology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, TanzaniaUniversity of Illinois College of Medicine, Chicago, Illinois, United StatesDepartment of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut, United StatesDiagnostic and Interventional Radiology, Lakeridge Health Corporation, Oshawa, Ontario, CanadaDivision of Interventional Radiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United StatesBackground Cervical cancer is the fourth most common cancer among women globally. Age-standardized cervical cancer mortality is higher in East Africa than anywhere else in the world. Prior to October 2018, patients presenting with obstructive uropathy secondary to late-stage cervical cancer in Tanzania who were no longer eligible for palliative chemoradiation therapy were discharged home without intervention. The purpose of this study was to evaluate whether the establishment of a percutaneous nephrostomy service in a quaternary hospital in Dar es Salaam, Tanzania, a resource-limited country, benefits patients who have late-stage cancer induced obstructive uropathy. Materials and Methods A retrospective study was performed on patients who presented with obstructive uropathy secondary to late-stage cervical cancer and have undergone percutaneous nephrostomy at Muhimbili National Hospital and Ocean Road Cancer Institute from October 2018 to May 2021. Twenty-one interventional radiology (IR) teaching teams consisting of IR attendings, IR technologists, and nurses travelled to Tanzania from North America on monthly 2-week trips during that period. A review of preprocedural, procedural, and follow-up data was performed using Research Electronic Data Capture. Statistical analysis and comparison were performed on patients' creatinine levels preprocedure, 7 days and 30 days postprocedure. Results Sixty-two patients qualified to be included in this study. In addition to the initial 62 nephrostomy placements, 14 follow-up procedures were performed either under visiting faculty supervision or independently by the Tanzanian IR fellows. Technical success rate was 98.7%. Complications (SIR Class A and B) occurred in eight cases. The average preprocedure creatinine (1051.48 ± 704.08µmol/L) decreased by 59% 7 days postprocedure and by 77% 30 days postintervention. Postprocedural clinical information was obtained for 28 (45.2%) patients and 18 were able to restart chemotherapy following nephrostomy. Conclusion Prior to 2018, percutaneous nephrostomy placement was not available in Tanzania. This study presented the initial safety, technical feasibility, and clinical benefit of establishing a percutaneous nephrostomy service in such a resource-limited setting.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0042-1744507percutaneous nephrostomycreatininechemotherapyobstructive uropathycervical cancer |
| spellingShingle | Ivan Rukundo Erick M. Mbuguje Azza Naif Manish Patel Fabian Laage-Gaupp Murray Asch Vijay Ramalingam Establishment of a Percutaneous Nephrostomy Service to Treat Obstructive Uropathy Secondary to Cervical Cancer in Tanzania The Arab Journal of Interventional Radiology percutaneous nephrostomy creatinine chemotherapy obstructive uropathy cervical cancer |
| title | Establishment of a Percutaneous Nephrostomy Service to Treat Obstructive Uropathy Secondary to Cervical Cancer in Tanzania |
| title_full | Establishment of a Percutaneous Nephrostomy Service to Treat Obstructive Uropathy Secondary to Cervical Cancer in Tanzania |
| title_fullStr | Establishment of a Percutaneous Nephrostomy Service to Treat Obstructive Uropathy Secondary to Cervical Cancer in Tanzania |
| title_full_unstemmed | Establishment of a Percutaneous Nephrostomy Service to Treat Obstructive Uropathy Secondary to Cervical Cancer in Tanzania |
| title_short | Establishment of a Percutaneous Nephrostomy Service to Treat Obstructive Uropathy Secondary to Cervical Cancer in Tanzania |
| title_sort | establishment of a percutaneous nephrostomy service to treat obstructive uropathy secondary to cervical cancer in tanzania |
| topic | percutaneous nephrostomy creatinine chemotherapy obstructive uropathy cervical cancer |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0042-1744507 |
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