Arellano-Cuadros JR, Pineda-Murillo J, Torres-Aguilar J, Sandoval-Salazar AFR

Language: Spanish
References: 15
Page: 202-206
PDF size: 437.80 Kb.

ABSTRACT

Background: Percutaneous nephrolithotomy (PCNL) was established as a minimally invasive treatment option for kidney stones in the 1970s and is considered a safe and effective procedure, with stone clearance rates of 78-95%. The ideal puncture should maximize the effectiveness of the procedure in terms of stone-free status and minimize the risk of complications.
Clinical case: We present the case of a 36-year-old male patient with bilateral lower back pain. A CT urography scan was performed that revealed bilateral lithiasis. The stone on the right side was consistent with an incomplete staghorn stone and a right retrorenal colon was identified. Left flexible nephrolithotripsy and subsequent right percutaneous nephrolithotomy were performed. A puncture was made under fluoroscopic guidance supported by previous digital dissection of all layers of the abdominal wall until gaining access to the retroperitoneum. Colonic lesion was prevented and a tunnel through which the renal unit could be palpated was formed.
Conclusions: The technique of digital insertion and dissection offers safe access to the renal unit that is useful in patients presenting with risk factors for a potential complication.

REFERENCES

1. Heer R, Veeratterapillay R, Haslam P, Hasan ST. A review and illustration of contemporary percutaneous nephrolithotomy practice using intracorporeal techniques through single punctures for complex stone burden in a UK tertiary referral centre. Br J Med Surg Urol. 2010;(3):144-150.

2. Amón JH, Pérez-Fentes D, Resel L, Galán JA, Serrano A, Servera A, et al. El aprendizaje de la nefrolitectomía percutánea en posición supina. Estudio observacional multicéntrico. Actas Urol Esp. 2013;37(4):214-220.

3. Ghani KR, Andonian S, Bultitude M, Desai M, Giusti G, Okhunov Z, et al. Percutaneous Nephrolithotomy: Update, Trends, and Future Directions. Eur Urol. 2016;(70):382-396.

4. Mak DKC, Smith Y, Buchholz N, El-Husseiny T. What is better in percutaneous nephrolithotomy-Prone or supine? A systematic review. Arab J Urol. 2016;(14):101-107.

5. Karaolides T, Moraitis K, Bach C, Masood J, Buchholz N. Positions for percutaneous nephrolithotomy: Thirty-five years of evolution. Arab J Urol. 2012;(10):307-316.

6. Ganpule AP, Vijayakumar M, Malpani A, Desai MR. Percutaneous nephrolithotomy (PCNL) a critical review. Int J Surg. 2016;(36):660-664.

7. Duty B, Okhunov Z, Smith A, Okeke Z. The Debate Over Percutaneous Nephrolithotomy Positioning: A Comprehensive Review. J Urol. 2011;(186);20-25.

8. Miller NL, Matlaga BR, Lingeman JE. Techniques for Fluoroscopic Percutaneous Renal Access. J Urol. 2007;(178):15- 23.

9. Zapata-González JA, Ramirez-Perez EA, López-Alvarado D, Corona-Martínez J. Acceso percutáneo al cáliz superior en posición supina: experiencia inicial. Rev Mex Urol. 2015;75(5):253-259.

10. El-Karamany T. A supracostal approach for percutaneous nephrolithotomy of staghorn calculi: A prospective study and review of previous reports. Arab J Urol. 2012;(10):358-366.

11. Nour HH, Kamal AM, Zayed AS, Refaat H, Badawy MH, El-Leithy TR. Single-step renal dilatation in percutaneous nephrolithotomy: A prospective randomised study. Arab J Urol. 2014;(12):219-222.

12. El-Assmy AM, Shokeir AA, Mohsen T, El-Tabey N, El-Nahas AR, Shoma AM, et al. Renal Access by Urologist or Radiologist for Percutaneous Nephrolithotomy-Is It Still an Issue? J Urol. 2007;(178):916-920.

13. Michel MS, Trojan L, Rassweiler JJ. Complications in Percutaneous Nephrolithotomy. Eur Urol. 2007;(51):899-906.

14. Nour HH, Kamal AM, Ghobashi SE, Zayed AS, Rushdy MM, El-Baz AG, et al. Percutaneous nephrolithotomy in the supine position: Safety and outcomes in a single-centre experience. Arab J Urol. 2013;(11):62-67.

15. Antonelli JA, Pearle MS. Advances in Percutaneous Nephrolithotomy. Urol Clin N Am. 2013;(40):99-113.