2005, Number 3
Percutaneous renal surgery. Supracostal and subcostal path
Marquina SM, Avalos VM
Full text
Language: Spanish
References: 14
Page: 192-196
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ABSTRACT
Introduction. Pecutaneous renal surgery has a role important in the treating the several pathologies like urolithiasis, stenosis of the union U/P and ureteral, upper tract collecting system tumors, diagnosis and derivation nephrostomy. Percutaneous renal surgery would be do for modern urologist and has to teach in the residence. The access the superior calyx gives a good vision at the rest of the calyxes and the union U/P, but the problem in the possible perforation of the pleura with the complications intrathoracic. Is a retrospective study that assessed the morbidity associated with supracostal and subcostal renal approaches. Material and methods. We review the records the patients with percutaneous renal surgery between April 1994 and August 2004. A total of 148 patients underwent percutaneous renal surgery: 129 patients by renal and ureteral calculi, 11 patients with stenosis U/P, five patients with stenosis ureteral and/or fistula urine and three patients with stenosis of the anastomosis ureteral with bladder in renal transplantation. In this study does not include the nephrostomy diagnosis or derivation because we did not have enough information. Results. Of 148 cases 95 patients had accesses subcostal, 41 had accesses supracostal and 12 had the two type accesses. The rate of the complications for accesses supracostal was of 20% and for subcostal was of 6.5% and overall percutaneous accesses was 11%. The complications include transfusions two cases, hydro and hemothorax two cases, sepsis and bacteremia seven cases, fistula nephropleural one case, emboli lung one case, neumothorax five cases. The eigth complications intrathoracic were associated with percutaneous accesses supracostal (15%). There were two deaths, one by lung embolus and the other by septic shock (1.3%). Conclusions. The percutaneous renal surgery is a excellent technique, it can resolve problems an the kidney and ureteral, in difficult cases like staghorn calculi, with low morbidity. The supracostal access sometimes is necessary to do it for when we have stenosis of the U/P union or complex calculi, even it is risk and we have intrathoracic complications, it is very important to do the diagnostic and treat them as soon is possible for avoid fatal consequents.REFERENCES