Outcome of Supracostal Puncture for Percutaneous Nephrolithotomy for Renal Stones: A Retrospective Analysis
Journal Title: International Journal of Medical Research Professionals - Year 2017, Vol 3, Issue 2
Abstract
Objective: Supracostal superior calyceal puncture is best puncture for staghorn, upper ureter, superior and inferior calyceal stone. The objective of this study is to analyzed the data from single centre regarding. The aim of this retrospective study was to evaluate a single center data regarding the safety and efficacy of this approach for percutaneous renal stone surgery. Materials and Methods: A total of 597 renal units (597 cases) were treated with percutaneous nephrolithotomy from the March of 2010 to March of 2015. Supracostal approach was selected in 123 cases and infracostal approach in remaining 474 cases. The indications of supracostal approach in our cases were staghorn and complex inferior calyceal stones, and stones in the upper calyx or the upper ureter. The urologist under C-arm fluoroscopic guidance in the prone position made all punctures. The interspace between 11th and 12th rib was used in 116 patients (94%) and 10th–11th interspace in 7 cases (6%). The operative time, success rate, hospital stay, and complications were evaluated. Results: The complete and relative success rates were 89.4 and 10.6%, respectively. The total complication rate was 13%. The success rate in the 10th– 11th rib access and 11th–12th inter rib access was 77 and 90%, respectively. Complete success rate was 100% in stone sizes less than 2 cm in diameter of upper ureteral and renal pelvic areas, and 77.4% of staghorn calculi. The total complication rate was 13% (16 cases), in which the most common of it was perioperative bleeding (5.7%; 7 cases). Conclusion: The supracostal approach was found to be effective as well as safe, with acceptable complications. It gives high stone clearance rates with acceptable morbidity rates and should be attempted in selected cases. The rate of pulmonary complications is higher with the supracostal approach. If the supracostal approach is indicated, it should be used with caution.
Authors and Affiliations
Nilesh Kumar Jain, Ankur Jhanwar, Sanjay Hada, Nitin Lashkary
Keywords
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- EP ID EP543834
- DOI 10.21276/ijmrp.2017.3.2.026
- Views 57
- Downloads 0
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