Colonic perforation during percutaneous nephrolithotomy: study of risk factors

Urology
Ahmed R El-NahasHamdy A El-Kappany

Abstract

To identify the risk factors implicated in colonic perforation during percutaneous nephrolithotomy. From 1985 to 2004, 5039 percutaneous nephrolithotomy procedures were performed in our center. Colonic perforation complicated 15 procedures (0.3%). The patient files were retrospectively reviewed for detection of preoperative risk factors as shown by multivariate statistical analysis. The operative details and postoperative course were also studied to determine the time and mode of diagnosis of colonic injury and treatment strategies and outcome. All injuries were retroperitoneal. The mean patient age was 57 +/- 8.4 years. Of the 15 patients, 11 were men and 4 were women. The left side was affected in 10 patients (66.6%). The right side was injured only in those with horseshoe kidneys or with recurrent disease. Colonic perforation complicated lower caliceal puncture in 12 procedures (80%) and complicated upper caliceal punctures in those with horseshoe kidneys or chronic colonic distension. Significant independent risk factors were advanced patient age and the presence of a horseshoe kidney. The diagnosis was established intraoperatively in 5 patients and postoperatively in 10, 5 of whom presented with colocutaneous fistula. The ...Continue Reading

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Citations

May 24, 2013·Surgical and Radiologic Anatomy : SRA·Hakan ÖnderMehmet Bulut
Jan 7, 2014·Current Opinion in Urology·Joyce BaardJean J M C H de la Rosette
Feb 28, 2008·Current Opinion in Urology·Steve K Williams, Raymond J Leveillee
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Apr 2, 2009·Journal of Endourology·Fernando KorkesEric R Wroklawski
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