Radiologic Relation of the Colon to the Trajectory of Percutaneous Nephrolithotomy Access in Prone Versus Flank-free Modified Supine Position: A Prospective Study of Intra and Interindividual Influencing Factors
| Autor: | A.M. Fawzi, Maged M Ali, Fatma Zaiton, Ahmed Eliwa, Esam Desoky, Hossam M. Abdel-Rahman, Ahmed Sakr, Aref Maarouf, Ashraf Shahin, Khalid Abdelwahab |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Flank Percutaneous Supine position Colon Urology medicine.medical_treatment 030232 urology & nephrology Axillary lines Nephrolithotomy Percutaneous Punctures Kidney Patient Positioning Body Mass Index 03 medical and health sciences Kidney Calculi 0302 clinical medicine Sex Factors medicine Prone Position Supine Position Humans Prospective Studies Prospective cohort study Percutaneous nephrolithotomy business.industry Age Factors Surgery Prone position 030220 oncology & carcinogenesis Female Radiology business Tomography X-Ray Computed Body mass index |
| Zdroj: | Urology. 115 |
| ISSN: | 1527-9995 |
| Popis: | To compare the distance between the colon and the trajectory of percutaneous nephrolithotomy (PCNL) access both in prone and flank-free modified supine (FFMS) positions as measured on computed tomography and to study the effect of age, gender, BMI, side, and previous renal surgery as influencing factors.In this prospective study, we included 367 patients scheduled for PCNL. All patients underwent low dose abdominal computed tomography both in prone and FFMS positions. Patients18 years and those with previous colonic surgery or renal congenital anomalies were excluded. The perpendicular distance between the imaginary line of the renal access and the colon was measured. Findings were correlated to different influencing factors.Two hundred nineteen patients were males, and 148 were females. BMI of30 were reported in 158 patients whereas BMI30 in 209 patients. Data analysis showed that the mean perpendicular distance between colon and the renal access in FFMS and prone positions were 35.92 ± 0.22 mm and 17.78 ± 0.09 mm, respectively. In prone position only obesity, age, and overall interaction effect were the significant factors on the studied distance. In FFMS position, in addition to the effect of the prior factors, previous renal surgery also significantly reduces this distance.The distance between the colon and assumed PCNL trajectory at a puncture on the posterior axillary line was influenced mainly by patient position. In FFMS position the colon appears to be farther than in prone position. BMI and age significantly influence this distance to a lesser extent. |
| Databáze: | OpenAIRE |
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