Upper-Pole Access for Percutaneous Nephrolithotomy: Comparison of Supracostal and Infracostal Approaches

Lojanapiwat, Bannakij; Prasopsuk, Songwut

doi:10.1089/end.2006.20.491

Cited by 117 publications

(102 citation statements)

References 13 publications

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“…The pulmonary complications that needed intercostal drainage were 5% and 0.3% in supracostal and subcostal approach, respectively. There was a 17-fold greater possibility of pulmonary complication in the supracostal when compared to the subcostal approach (12).…”

Section: Commentsmentioning

confidence: 98%

“…The upper pole approach provides a straight tract along the long axis of the kidney and ensures reaching most of the collecting system, which provides easier manipulation of the rigid nephroscope and other rigid instruments. This approach can achieve a better stone clearance (12,13). Upper pole access can be achieved via the supracostal and infracostal approaches.…”

Section: Commentsmentioning

confidence: 99%

“…An Amplatz sheath is used in all patients during the percutaneous supracostal approach to maintain low pressure irrigation that can reduce the risk of pleural effusion and extravasation. After supracostal access, postoperative CXRs were routinely used in all cases for evaluation of pulmonary complications (12).…”

Section: Commentsmentioning

confidence: 99%

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Supracostal access: does it affect tubeless percutaneous nephrolithotomy efficacy and safety?

Jun-Ou

Lojanapiwat

2010

Int. braz j urol.

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Introduction: Tubeless percutaneous nephrolithotomy (PCNL) in selected patients has been found to be safe and can reduce postoperative discomfort without increasing complications. The challenges of tubeless PCNL via supracostal access are inadequate drainage and postoperative bleeding, conditions that may increase pulmonary complications. We compare the efficacy and safety of the tubeless supracostal versus the standard supracostal PCNL. Materials and Methods: Supracostal PCNL with one percutaneous renal access, no significant bleeding, extravasation and residual stone was performed in 95 patients. Of these, 43 were tubeless PCNL (Group-I) and 52 were PCNL with standard routine postoperative nephrostomy tube (Group-II). In group-I, PCNL was done by the standard supracostal technique with the placement of a postoperative external ureteral catheter for 48 hours. The operative time, success rate, hospital stay and ensuing complications were compared between group-I and group-II. Results: Patients in the tubeless PCNL group (Group-I) were 90.7% stone -free while those with standard routine postoperative nephrostomy tube(Group-II) were 84.6% stone -free. Additionally, stone fragments of less than 4 mm in diameter were found in 9.3% of patients in group-I and 25.4% in group-II. The success rate, hematocrit change and complication were not significantly different between both groups. The analgesic requirement, operative time and hospital stay were all significantly less in the tubeless supracostal group (Group-I). None of group I and only one patient of group II needed intercostal drainage. Conclusion: Tubeless supracostal percutaneous nephrolithotomy in selected patients is effective with acceptable complications. This technique offers the advantage of lower analgesic requirement, shorter operative time and hospital stay. The pulmonary complication is the same as the standard supracostal percutaneous nephrolithotomy.

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Section: Commentsmentioning

confidence: 98%

Section: Commentsmentioning

confidence: 99%

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Supracostal access: does it affect tubeless percutaneous nephrolithotomy efficacy and safety?

Jun-Ou

Lojanapiwat

2010

Int. braz j urol.

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“…1,2 Thorough preoperative assessment was carried out, all relevant investigations were noted. Patients fulfilling the inclusion criteria were explained about the study.…”

Section: Introductionmentioning

confidence: 99%

A comparative study of combined spinal epidural anaesthesia and general anaesthesia in patients undergoing percutaneous nephrolithotomy

et al. 2016

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“…Percutaneous nephrolithotomy (PCNL) is the treatment of choice for large renal calculi, staghorn calculi and calculi which fail treatment with extracorporeal shockwave lithotripsy and ureteral endoscopy (1)(2)(3). PCNL can be performed under general anesthesia, regional anesthesia or local anesthesia.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of percutaneous nephrolithotomy (PCNL): a prospective and randomized study comparing regional epidural anesthesia with general anesthesia

2012

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Objective: To compare the efficacy and safety of regional epidural anesthesia and general anesthesia in patients who underwent PCNL. Materials and Methods: Fifty patients submitted to percutaneous nephrolithotomy (PCNL) were randomized into two groups: Group I (N = 26) received general anesthesia and Group II (N = 24) received regional epidural anesthesia. Demographic and operative data including age, BMI, stone position, stone size, postoperative pain, amount of postoperative analgesic usage, length of hospital stay, patient satisfaction, preoperative and postoperative hemoglobin and hematocrit, adverse effects and surgical complications were compared between both groups.

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Upper-Pole Access for Percutaneous Nephrolithotomy: Comparison of Supracostal and Infracostal Approaches

Cited by 117 publications

References 13 publications

Supracostal access: does it affect tubeless percutaneous nephrolithotomy efficacy and safety?

Supracostal access: does it affect tubeless percutaneous nephrolithotomy efficacy and safety?

A comparative study of combined spinal epidural anaesthesia and general anaesthesia in patients undergoing percutaneous nephrolithotomy

Efficacy and safety of percutaneous nephrolithotomy (PCNL): a prospective and randomized study comparing regional epidural anesthesia with general anesthesia

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