Supracostal Approach in Percutaneous Nephrolithotomy: Experience with 102 Cases

Kekre, Nitin S; Gopalakrishnan, Ganesh; Gupta, Girdhar Gopal; Abraham, Bejoy N.; Sharma, Elias

doi:10.1089/089277901753205753

Cited by 65 publications

(39 citation statements)

References 9 publications

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“…But in our study complication rate is low and patient can be managed symptomatically. (Kekre et al, 2001) Bjurlin et al in his study of 214 patients with 21 % intercostals access found chest x-ray routinely as unnecessary practice. Low complication rates of procedure along with symptomatology can displace routine chest x ray.…”

Section: Resultsmentioning

confidence: 98%

To Find Role of Routine Chest X Ray in Case of Supracostal PCNL: Can Complains and Physical Examination Replace it

Pawar¹,

Kumar²,

Singh³

et al. 2016

Int.J.Curr.Microbiol.App.Sci

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Section: Resultsmentioning

confidence: 98%

To Find Role of Routine Chest X Ray in Case of Supracostal PCNL: Can Complains and Physical Examination Replace it

Pawar¹,

Kumar²,

Singh³

et al. 2016

Int.J.Curr.Microbiol.App.Sci

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“…Yüz iki, 1350, 240 olguluk faklı serilerde suprakostal PNL girişimlerinde intratorasik komplikasyon oranları sırasıyla; %10, %20, %1,8 olarak bildirilmiş ve suprakostal girişimlerde subkostal girişime göre daha fazla yan etki oranı belirtilmiştir (11)(12)(13). Yazkan ve ark.…”

Section: Discussionunclassified

Evaluation of Pleural Following after Percutaneous Nephrolithotomy: An Analysis of 49 Cases

Akar¹,

Haberal²,

Öner³

et al. 2016

Haseki

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Aim: Thoracic complications developing after percutaneous nephrolithotomy and the efficacy of their treatment were studied. Methods:Among 2527 patients who were operated on using the percutaneous nephrolithotomy technique for kidney stones between November 2003 and August 2014, the medical records of 49 patients who had intrathoracic pathologies after the procedure were retrospectively reviewed.Results:It was observed that pleural effusion developed in 49 patients who were operated with percutaneous nephrolithotomy. The mean age of the patient population was 46.1 years and the age range was 13-85 years. Nineteen (39%) patients were female and 30 (61%) were male. A supracostal intervention was applied in 40 (82%) patients. A subcostal intervention was applied in nine (18%) patients. Seven (78%) of the subcostal interventions were performed above 12 th rib and 2 (22%) above 11 th rib. After percutaneous nephrolithotomy operation, a hemorrhagic pleural effusion developed in 43 (88%) patients and hydropneumothorax in six (12%) patients. Conclusion:Percutaneous nephrolithotomy is a cause of iatrogenic thoracic complications and pleura and lungs are reportedly the most commonly injured organs. In the case of early postoperative, a posteroanterior chest x-ray should be obtained for an early diagnosis of thoracic complications. Tube thoracostomy usually suffices for these types of complications.

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“…Overall, the occurrence of pulmonary complications in our series was comparable with prior series. [2][3][4][5][6][7] Using a working sheath of adequate size during PCNL via the supracostal approach may prevent pleural complications. We believe that it is important to keep a low pressure within the irrigation system during PCNL to minimize the possibility of fluid entering the pleural space.…”

Section: Discussionmentioning

confidence: 99%

“…The advantage of the superior calyceal approach in percutaneous renal surgery has been reported by many authors. [2][3][4][5][6][7] However, it is usually a concern because of the potential complications of pneumothorax, hydrothorax, pleural effusion, and lung injury.…”

mentioning

confidence: 99%

Supracostal Approach for PCNL: Is 10th and 11th Intercostal Space Safe According to Clavien Classification System?

Kara

Değirmenci

Kozacıoğlu

et al. 2014

International Surgery

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patients underwent PCNL, 243 of whom had a supracostal access. The interspace between the 11th and 12th rib was used in 204 cases (group 1) and between the 10th and 11th interspaces in 39 cases (group 2). PCNL was performed using standard supracostal technique in all patients. The operative time, success rate, hospital stay, and complications according to the modified Clavien classification were compared between group 1 and group 2. The stone-free rate was 86.8% in group 1 and 84.6% in group 2 after one session of PCNL. Auxiliary procedures consisting of ureterorenoscopy (URS) and shock wave lithotripsy (SWL) were required in 5 and 7 patients, respectively, in group 1; and in 1 patient each in group 2. After the auxiliary procedures, stone-free rates increased to 92.6% in group 1 and 89.7% in group 2. A total of 74 (30.4%) complications were documented in the 2 groups according to modified Clavien classification. Grade-I complications were recorded in 20 (8.2%), grade-II in 38 (15.6%), grade-IIIa in 13 (5.3%), and grade-IIIb in 2 (0.8%) patients; grade-IVa was recorded in 1 (0.4%) patient. There were no grade-IVb or grade-V complications. Overall complication rate was 30.9% in group 1 and 28.2% in group 2. Supracostal PCNL in selected cases is effective and safe with acceptable complications. The modified Clavien system provides a standardized grading system for complications of PCNL.

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Supracostal Approach in Percutaneous Nephrolithotomy: Experience with 102 Cases

Abstract: Supracostal puncture in a safe and effective approach with acceptable morbidity in selected cases of staghorn, upper ureteral, and upper caliceal calculi.

Cited by 65 publications

References 9 publications

To Find Role of Routine Chest X Ray in Case of Supracostal PCNL: Can Complains and Physical Examination Replace it

To Find Role of Routine Chest X Ray in Case of Supracostal PCNL: Can Complains and Physical Examination Replace it

Evaluation of Pleural Following after Percutaneous Nephrolithotomy: An Analysis of 49 Cases

Supracostal Approach for PCNL: Is 10th and 11th Intercostal Space Safe According to Clavien Classification System?

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