Direct Percutaneous Approach to the Upper Pole of the Kidney: MRI Anatomy with Assessment of the Visceral Risk

Robert, M.; Maubon, A.; Roux, Jennifer; Rouanet, J. P.; Navratil, H

doi:10.1089/end.1999.13.17

Cited by 25 publications

(11 citation statements)

References 12 publications

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“…The drawback of supracostal punctures is an increased incidence of intrathoracic complications as well as a higher rate of spleen and hepatic injury. [11][12][13] The use of supra twelfth rib punctures, perhaps reflecting the small throughput in a number of hospitals, was limited to only 6% of cases and none of whom had any complications.…”

Section: Complicationsmentioning

confidence: 99%

Contemporary Practice of Percutaneous Nephrolithotomy: Review of Practice in a Single Region of the UK

Srirangam

Darling

Stopford

et al. 2008

annals

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Ann R Coll Surg Engl 2008; 90: 40-44 40Percutaneous nephrolithotomy (PCNL) has become the mainstay of treatment for large renal calculi over the past 30 years since Fernstrom and Johansson first removed a renal calculus through a nephrostomy tract in 1976. 1 The practice of PCNL, having been refined over time, continues to evolve and has largely replaced open stone surgery for the treatment of complex upper tract stones unsuitable for extracorporeal shockwave lithotripsy (ESWL) or ureteroscopy. This has been aided by advances in technology and equipment resulting in stone removal with less morbidity, shorter convalescence, and reduced cost compared with open surgery. 2,3 Excellent outcomes have been reported following PCNL with stone-free rates approaching 95%. Nevertheless, most published series of PCNL are from single centres with a dedicated sub-specialist interest in stone management.These represent optimum results achievable and may not reflect outcomes of everyday practice in non-specialised units. The aim of the study was to analyse the current practice of PCNL in our region. Patients and MethodsThe region comprises 12 participating hospital trusts. Of these, two were tertiary referral centres with a recognised expertise in stone management, while the rest (10) comprised district general hospitals (secondary centres) providing a range of urological interventions. All patients undergoing a PCNL procedure in 2002 were identified using theatre records and medical records scrutinised retrospectively. In trusts performing more than 20 procedures

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Section: Complicationsmentioning

confidence: 99%

Contemporary Practice of Percutaneous Nephrolithotomy: Review of Practice in a Single Region of the UK

Srirangam

Darling

Stopford

et al. 2008

annals

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“…22 In addition, preoperative cross-sectional imaging with CT or MRI can further clarify structures adjacent to the kidney when a supracostal puncture is planned. 23 In general, the skin incision for puncture should lie between the posterior axillary line and the spine to protect adjacent organs from injury. The puncture site for percutaneous access in thin patients should be more medial and superior.…”

Section: Preventing Splenic Injurymentioning

confidence: 99%

Splenic Injury During Percutaneous Nephrolithotomy: A Case Report with Novel Management Technique

Desai

Jain

Benway

et al. 2010

Journal of Endourology

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We describe a case of a splenic injury caused by a transsplenic percutaneous nephrostomy tract. The case was completed without incident and the nephrostomy tube was noted to traverse the spleen on routine postoperative imaging. This rare complication was managed by deposition of Gelfoam Ò pledgets along the transsplenic nephrostomy tract and placement of a ureteral stent. This novel management technique has not been previously described in the literature and was successful in the conservative treatment of the uncommon complication of splenic injury during percutaneous nephrolithotomy.

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“…As a matter of fact, the renal artery divides into two major branches, ventral and dorsal, and its division creates an avascular zone known as Brödel's line, which lies between the vascular districts of the ventral and dorsal branch of the renal artery [41,42]. The use of this area for renal puncture should lower the risk of bleeding complications [16,41,42,[45][46][47][48][49]. In our study ultrasound was used to perform the procedure (it confirms the correctness of the approach, locates the calyx of the lower group to be pricked and visualises needle position and advancement in real time) together with fluoroscopy (which allows checking needle position and following catheter progression).…”

Section: (Tabella 3)mentioning

confidence: 99%

“…L'utilizzo di tale area per la puntura renale ridurrebbe il rischio di complicanze emorragiche [16,41,42,[45][46][47][48][49].…”

Section: (Tabella 3)unclassified

Complications of percutaneous nephrostomy in the treatment of malignant ureteral obstructions: single–centre review

et al. 2006

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PCN is a method with a high percentage of technical success with low rate of complications thanks to combined use of sonographic and fluoroscopic guidance for the procedure. The OST technique is indicated for a highly remarkable hydronephrosis and in cases where the catheter is only placed for a short period. The Seldinger technique is carried out in patients with grades II and III hydronephrosis and if the disease is predicted to have a long duration.

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Direct Percutaneous Approach to the Upper Pole of the Kidney: MRI Anatomy with Assessment of the Visceral Risk

Abstract: A percutaneous puncture of the upper pole of the kidney above the 11th rib increases the risk of visceral damage. Preoperative evaluation, with the aid of CT scan or MRI, of the risk of pulmonary, splenic, or hepatic injury could be carried out in these cases.

Cited by 25 publications

References 12 publications

Contemporary Practice of Percutaneous Nephrolithotomy: Review of Practice in a Single Region of the UK

Contemporary Practice of Percutaneous Nephrolithotomy: Review of Practice in a Single Region of the UK

Splenic Injury During Percutaneous Nephrolithotomy: A Case Report with Novel Management Technique

Complications of percutaneous nephrostomy in the treatment of malignant ureteral obstructions: single–centre review

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