Intercostal-space nephrostomy for percutaneous stone removal

Picus, Daniel; Weyman, Philip J.; Clayman, Ralph V.; McClennan, Bruce L.

doi:10.2214/ajr.147.2.393

Cited by 87 publications

(35 citation statements)

References 8 publications

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“…3). Others have reported the incidence of hydrothorax to be 0-12% [7,13]. The cause of hydrothorax has been attrib- uted to a failure to seal the tract with the working sheath during the procedure, or inadequate drainage of the kidney afterward.…”

Section: Discussionmentioning

confidence: 99%

“…The optimal access for the staghorn, large upper calyceal and complex renal stone burden is through the upper pole posterior calyx, which at times is best accomplished by supracostal puncture [1]. The supracostal puncture is usually a concern because of the potential complications of pneumothorax, hydrothorax and lung injury [2][3][4]; hydrothorax has been reported in 6-32% of procedures [5][6][7][8]. We prospectively evaluated the safety and efficacy of the supracostal approach for the percutaneous removal of staghorn and complex renal stones.…”

Section: Introductionmentioning

confidence: 99%

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Prospective evaluation of safety and efficacy of the supracostal approach for percutaneous nephrolithotomy

et al. 2002

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prospective evaluation of safety and efficacy of the supracostal approach for percutaneous nephrolithotomy

et al. 2002

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“…(Reprinted, with permission, from reference 3.) supracostal entries (39,40) (Fig 19). Complica tions related to violation of the pleural space are likely to increase in number with the greater use of access to the upper-pole collecting system for stone therapy.…”

Section: Complications Of Percutaneous Renal Entrymentioning

confidence: 99%

Percutaneous Nephrostomy with Extensions of the Technique: Step by Step

Dyer¹,

Regan²,

Kavanagh³

et al. 2002

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Minimally invasive therapy in the urinary tract begins with renal access by means of percutaneous nephrostomy. Indications for percutaneous nephrostomy include urinary diversion, treatment of nephrolithiasis and complex urinary tract infections, ureteral intervention, and ne phroscopy and ureteroscopy. Bleeding complications can be minimized by entering the kidney in a relatively avascular zone created by branch ing of the renal artery. The specific site of renal entry is dictated by the indication for access with consideration of the anatomic constraints. Successful percutaneous nephrostomy requires visualization of the col lecting system for selection of an appropriate entry site. The definitive entry site is then selected; ideally, the entry site should be subcostal and lateral to the paraspinous musculature. Small-bore nephrostomy tracks can be created over a guide wire coiled in the renal pelvis. A large-diameter track may be necessary for percutaneous stone therapy, nephroscopy, or antegrade ureteroscopy. The most common extension of percutaneous nephrostomy is placement of a ureteral stent for treat ment of obstruction. Transient hematuria occurs in virtually every pa tient after percutaneous nephrostomy, but severe bleeding that requires transfusion or intervention is uncommon. In patients with an ob structed urinary tract complicated by infection, extensive manipula tions pose a risk of septic complications.

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“…Complications have been described like hydrothorax. haemothorax, pneumothorax haemo-pneumothorax, hydropneumothorax, lung contusion, liver and spleen injuries etc., (Picus et al, 1986;Hopper et al, 1990) To detect all these complication standard c xray post operatively is done to in all these patients. But this chest x ray is not with out any controversies.…”

Section: Resultsmentioning

confidence: 99%