J.A. Zapata-Gonzalez , E.A. Ramirez-Pérez , D. López-Alvarado , J. Corona-Martinez
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引用次数: 1
Abstract
Background
The correct choice for the percutaneous puncture site is key to the success of any percutaneous nephrolithotomy. The ideal puncture should maximize the effectiveness of the procedure in terms of stone-free rate and minimize the risk for complications. It is necessary to correctly choose the calyx to be accessed; in certain cases the upper calyx is the ideal site.
Aims
To report our experience with the percutaneous approach to the upper pole with patients in the supine position.
Methods
A retrospective, observational, descriptive study was carried out on patients with stones in the renal pelvis or upper calyx treated through percutaneous nephrolithotomy.
Results
A total of 17 patients were included in the study, and 17 kidney units were treated. All 17 patients (100%) underwent general anesthesia. Nine (53%) of the patients were men and 8 (47%) were women, with a mean age of 45.8 years (range: 18-72). Stone site was the right kidney in 10 (59%) patients and the left in 7 (41%). A total of 13 (76%) patients were symptomatic. The mean body mass index was 27 kg/m2 (range: 20-34). ASA classification was I in 13 (76.4%) patients, II in 3 (17.6%) patients, and III in one (5.8%) patient. Eight (47%) patients underwent previous treatments. Procedure success or stone-free rate was achieved in 14 (82.3%) patients with the first treatment and in 17 (100%) with the second treatment.
Discussion
Current knowledge of the pleural and diaphragmatic anatomy, the use of real time ultrasound for percutaneous puncture, and the development of new surgical techniques have considerably reduced the risk for intrathoracic complications.
Conclusions
Access to the upper calyx with the patient in the supine position is safe and reproducible. This approach provides excellent vision of the entire pyelocaliceal system and should be reserved for cases in which the lower calyx is not the best option.
期刊介绍：
Revista Mexicana de Urología (RMU) [Mexican Journal of Urology] (ISSN: 0185-4542 / ISSN electronic: 2007-4085) is bimonthly publication that disseminates research by academicians and professionals of the international medical community interested in urological subjects, in the format of original articles, clinical cases, review articles brief communications and letters to the editor. Owing to its nature, it is publication with international scope that disseminates contributions in Spanish and English that are rigorously reviewed by peers under the double blind modality. Neither journalistic documents nor those that lack rigorous medical or scientific support are suitable for publication.
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