Title: To Study the Outcomes of Supracostal and Infracostal Access Approach in Treating Renal Calculi using PCNL (Percutaneous Nephrolithotomy)
Authors: Dr Ashutosh Kesar, Dr Kulbir Singh Jat, Dr Amit Suri
DOI: https://dx.doi.org/10.18535/jmscr/v7i4.180
Abstract
The lifetime prevalence of kidney stone disease is estimated at 1% to 15% with the probability of having a stone varying according to age, gender, race and geographical location (Margeret S. pearle et al 2007)8. In Indian scenario urolithiasis constitutes one of the commonest reason requiring surgical intervention and approximately about 5-7 million patients suffer from calculus disease.
Aims and Objectives: To evaluate two levels of renal access in PCNL one supracostal and other infracostal and will evaluate their outcomes in terms of:
- Number of access puncture sites required for complete stone clearance
- Stone clearance rates
- Safety
- Efficacy (Stone free status post op KUB)
- Complications
Materials and Methods: This study entitled “To Study the Outcomes of Supracostal and Infracostal Access Approach in Treating Renal Calculi using PCNL (Percutaneous Nephrolithotomy)” was conducted in the Post-graduate Department of Surgery, Acharya Shri Chander College of Medical Sciences and Hospital, Jammu from 1st Nov 2016 to 31st Oct 2017.
The site of calyceal puncture in supracostal group was superior calyx in 21 (70%), Middle calyx in 8 (26.67%) and inferior calyx in 1 (3.33%) of patients respectively, while in the infracostal group it was superior calyx in 5 (16.67%), middle calyx in 12 (40%) and inferior calyx in 13 (43.33%) patients respectively
Keywords: probability ,urolithiasis
References
- Curhan GC, Willet WC, Rimm EB, Stampfer MJ: Family history and risk of kidney stones. Journal of the American Society of Nephrology 1997a; 8:1568-73.
- Finelli A. Honey RJ. Thoracoscopy-assisted high intracostal percutaneous access. Journal of Endourology 2001;15(6):581–584.
- Galvin DJ, Pearle MS. The contemporary management of renal and ureteric calculi. British Journal of Urology Int. 2006;98(6):1283–1288
- Golijanin D, Katz R, Verstanding A, Sasson T, Landau EH, Meretyk S. The supracostal percutaneous nephrostomy for treatment of staghorn and complex kidney stones. Journal of Endourology 1998;12(5):403–405.
- Hopper KD, Yakes WF. The posterior intercostal approach for percutaneous renal procedures: Risk of puncturing the lung, spleen, and liver as determined by CT. American Journal of Roentgenology 1990;154:115–7.
- James E Lingeman, Brian R Matlaga, Andrew P Evan: Surgical management of upper urinary tract calculi. Campbell-Walsh Urology 2007; Volume 2, Ch 44:1434
- Kekre NS, Gopalakrishnan GG, Gupta GG, Abraham BN, Sharma E. Supracostal approach in percutaneous nephrolit-hotomy: experience with 102 cases. Journal of Endourology 2001;15(8):789–791.
- Margeret S. Pearle, Yair Lotan. Urinary lithiasis: Etiology, epidemiology, and pathogenesi. Campbell-Walsh Urology 2007; Volume 2, Ch 42: 1363-73
- Mc Geown MG: Heredity in renal stone disease. Clinical Science 1960; 19:465.
- Modlin M:A history of urinary stone. South African Medical journal 1980 Oct 18; 58(16): 652-55
- Mousavi-Bahar SH, Mehrabi S, Moslemi MK. The safety and efficacy of PCNL with supracostal approach in the treatment of renal stone. International Urology and Nephrology. 2011;43(4):983–987.
- Munver R, Delvecchio FC, et al Critical analysis of supracostal access for percutaneous renal surgery. Journal of Urology 2001;166:1242–6.
- Muzrakchi AA, Szmigielski W, Omar AJ, Younes NM. Is the 10th and 11th intercostal space a safe approach for percutaneous nephrostomy and nephrolithotomy? Cardiovascular and Interventional Radiology 2004;27(5):503–506.
- Resnick M, Pridgen DB, and goodman HO: Genetic predisposition to formation of calcium oxalate renal calculi. New England Journal of Medicine 1968; 278:1311-18.
- Sukumar S, Niar B, Kumar PG, Sanjeevan KV, Bhat HS. Supracostal access for percutaneous nephrolithotomy: less morbid, more effective. International Urology and Nephrology: 2008;40(2):263–267.