Is the 10th and 11th intercostal space a safe approach for percutaneous nephrostomy and nephrolithotomy?

Cardiovascular and Interventional Radiology
Ahmed Al MuzrakchiNagy M Younes

Abstract

The aim of this study was to determine the rate of complications in percutaneous nephrostomy (PCN) and nephrolithotomy (PCNL) performed through the 11th and 10th intercostal spaces using our monitoring technique and to discuss the safety of the procedure. Out of 398 PCNs and PCNLs carried out during a 3-year period, 56 patients had 57 such procedures performed using an intercostal approach. The 11th intercostal route was used in 42 and the 10th in 15 cases. One patient had two separate nephrostomies performed through the 10th and 11th intercostal spaces. The technique utilizes bi-planar fluoroscopy with a combination of a conventional angiographic machine to provide anterior-posterior fluoroscopy and a C-arm mobile fluoroscopy machine to give a lateral view, displayed on two separate monitors. None of the patients had clinically significant thoracic or abdominal complications. Two patients had minor chest complications. Only one developed changes (plate atelectasis, elevation of the hemi-diaphragm) directly related to the nephrostomy (2%). The second patient had bilateral plate atelectasis and unilateral congestive lung changes after PCNL. These changes were not necessarily related to the procedure but rather to general anesthe...Continue Reading

Citations

Jan 9, 2007·Journal of Endourology·Hemendra N ShahManish Bansal
Sep 30, 2009·Journal of Endourology·Pankaj N MaheshwariAshish B Pathak
Feb 20, 2014·Journal of Endourology·Michelle LightfootD Duane Baldwin
Dec 1, 2009·Techniques in Vascular and Interventional Radiology·Wael E A SaadDaniel Ginat
Aug 20, 2010·Journal of Medical Imaging and Radiation Oncology·S ChoiL Ridley
Apr 22, 2011·Science China. Life Sciences·Haiying Shen, Wonchae Choe

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