Sensitivity of chest fluoroscopy compared with chest CT and chest radiography for diagnosing hydropneumothorax in association with percutaneous nephrostolithotomy

Ogan, Kenneth; Corwin, T. Spark; Smith, Thomas H.; Watumull, Lori M; Mullican, Mary A.; Cadeddu, Jeffrey A.; Pearle, Margaret S.

doi:10.1016/j.urology.2003.07.024

Cited by 56 publications

(22 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This finding correlated well with previously published series [13,21] . The risk of intrathoracic complications in patients managed with intercostal access, which was found to be 8.7% in the present study, has been reported to range between 5 and 16.3% in the literature, and increases in those punctured above 11th rib [10,11,13] .…”

Section: Discussionsupporting

confidence: 50%

Impact of Percutaneous Access Point Number and Location on Complication and Success Rates in Percutaneous Nephrolithotomy

et al. 2006

View full text Add to dashboard Cite

Objectives: Percutaneous nephrolithotomy (PNL) is sometimes associated with complications, especially in patients with complex stones. Herein, we review our experience with PNL to determine the impact of percutaneous access number and location on success and complication rates. Patients and Methods: During a 2-year period, a total of 275 patients with a mean age of 42.3 ± 14.8 (range: 13–75) years underwent PNL. Stones were classified as simple in 51.6%, and complex (staghorn calculi or renal pelvis stones coexisting with caliceal stones) in 48.4%. Percutaneous access was done under C-armed fluoroscopy and the tract was formed with a high-pressure balloon dilation system. One single percutaneous access was sufficient in 210 (76.4%), while 2 accesses were utilized in 44 (16%), and ≧3 accesses in 21 cases (7.6%). Supracostal access was performed in 23 (8.4%) patients. Results: An overall success rate of 94.9% was achieved. Stone location, but not the access point location, was the major determinant for success, which was 99.3 and 90.2% in patients with simple and complex stones, respectively (p < 0.01). Significant complications included bleeding necessitating blood transfusion in 28 (10.2%), and hydropneumothorax in 2 (0.7%) patients. Bleeding was observed in 39.1 and 7.5% of patients managed with supracostal access, and subcostal access, respectively (p < 0.01). An increased number of access points significantly augmented the risk for bleeding. Bleeding was encountered in 7.6% of patients managed with 1 percutaneous access point, and in 18.5% of cases managed with ≧2 access points (p < 0.05). Hydropneumothorax occurred in patients with supracostal access. Conclusion: Supracostal access as well as multiple punctures may be needed especially in the management of complex stones, and the need for multiple access points and supracostal access significantly increases complication rates.

show abstract

Section: Discussionsupporting

confidence: 50%

Impact of Percutaneous Access Point Number and Location on Complication and Success Rates in Percutaneous Nephrolithotomy

et al. 2006

View full text Add to dashboard Cite

show abstract

“…In a previous prospective series of 89 consecutive patients (100 renal units) undergoing PCNL SLFN was done in 18% of renal units, including 1 patient (6%) with hydropneumothorax at the second procedure. 10 At our institution the estimated average direct cost of SLFN, including surgeon fee, operating room cost and additional length of stay, was $2,475. In this study we determined that the cost of an expectant management strategy for RFs 4 mm or less was $1,743 per patient, ie the average cost according to the proportion of patients indicated by the model who accrued the cost of a stone related event with or without surgical intervention.…”

Section: Discussionmentioning

confidence: 94%

Residual Fragments After Percutaneous Nephrolithotomy: Cost Comparison of Immediate Second Look Flexible Nephroscopy Versus Expectant Management

et al. 2010

View full text Add to dashboard Cite

Our model suggests that second look flexible nephroscopy is not cost advantageous in all patients with post-percutaneous nephrostolithotomy residual fragments. Cost benefit analysis is significantly impacted by the likelihood of a stone related event, the need for surgical intervention and surgical costs. Compared to an observational strategy second look flexible nephroscopy incurs lower costs for greater than 4 mm but not for 4 mm or less residual fragments.

show abstract

“…3 The most important disadvantage of the supracostal approach is its associated pleural complications, with a rate ranging from 0 to 37%. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] It is believed that placing a large nephrostomy tube at the end of procedure could limit these complications by allowing free drainage of urine and tamponading the PCNL tract, but such tubes are associated with more postoperative pain and analgesic use. 16 Tubeless PCNL is advocated increasingly in the literature.…”

Section: Introductionmentioning

confidence: 99%

Safety and Efficacy of Supracostal Access in Tubeless Percutaneous Nephrolithotomy

Shah

Hegde

Shah

et al. 2006

Journal of Endourology

View full text Add to dashboard Cite

show abstract

Sensitivity of chest fluoroscopy compared with chest CT and chest radiography for diagnosing hydropneumothorax in association with percutaneous nephrostolithotomy

Cited by 56 publications

References 10 publications

Impact of Percutaneous Access Point Number and Location on Complication and Success Rates in Percutaneous Nephrolithotomy

Impact of Percutaneous Access Point Number and Location on Complication and Success Rates in Percutaneous Nephrolithotomy

Residual Fragments After Percutaneous Nephrolithotomy: Cost Comparison of Immediate Second Look Flexible Nephroscopy Versus Expectant Management

Safety and Efficacy of Supracostal Access in Tubeless Percutaneous Nephrolithotomy

Contact Info

Product

Resources

About