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- W1984867266 abstract "You have accessJournal of UrologyStone Disease: New Technology/SWL, Ureteroscopic or Percutaneous Stone Removal1 Apr 20111819 RENAL AND PERIRENAL ANATOMY IN THE SUPINE AND PRONE POSITION: IMPLICATIONS FOR PERCUTANEOUS STONE TREATMENT Brian Eisner, Kevin McLaughlin, Kim Stein, Naveen Kulkarni, and Dushyant Sahani Brian EisnerBrian Eisner Boston, MA More articles by this author , Kevin McLaughlinKevin McLaughlin Boston, MA More articles by this author , Kim SteinKim Stein Boston, MA More articles by this author , Naveen KulkarniNaveen Kulkarni Boston, MA More articles by this author , and Dushyant SahaniDushyant Sahani Boston, MA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1838AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES There is a risk of injury to surrounding organs (i.e. pleura, liver, spleen, colon) during prone percutaneous nephrolithotomy. However, preoperative planning is often done based on supine computed tomography (CT), which is a common method of performing CT scan in patients with nephrolithiasis. The purpose of this study was to examine the changes in renal and perirenal anatomy when patients change from the supine to prone position. METHODS 50 patients without a history of nephrolithiasis who were scheduled for hematuria protocol CT scan at our institution were included in this retrospective study. Our standard hematuria protocol CT scan is to perform supine unenhanced CT followed by prone contrast-enhanced CT with delayed images. The desired calyx of entry for percutaneous upper and lower pole puncture was identified, and then relevant anatomical measurements (i.e. distance from puncture tract to pleura and surrounding organs) were performed. Measurements were performed by 2 independent observers. Statistical analysis utilized student's t-test and chi-square analysis. RESULTS 50 patients were analyzed (100 renal units). M:F ratio was 21:30 and mean age was 54.9 (SD 15.6). For the right upper pole, puncture distance was silimar for supine and prone positions (7.5 cm versus 7.9 cm, p= 0.23), distance from the puncture tract to the liver was higher for the prone position (prone = 5.1 cm versus supine = 4.3 cm, p=0.005), and transpleural punctures was significantly greater for the prone position (prone = 40%, supine = 0%, p < 0.0001). For the left upper pole, puncture distance was silimar for supine and prone positions (7.4 cm versus 7.9 cm, p=0.1), and transpleural punctures was significantly higher for prone position (prone =14%, supine = 0%, p = 0.001). For the right lower pole, puncture distance was greater for supine position (supine = 8.3 cm versus prone = 7.1 cm, p=0.02), and transcolonic punctures were similar (supine = 4%, prone = 2%, p=0.55). For the left lower pole, puncture distance was similar (supine = 7.9 cm, prone = 7.7, p=0.6), and transcolonic punctures were not significant (but approached statistical significance) (supine = 2%, prone = 10%, p=0.07). CONCLUSIONS Renal and perirenal anatomy may change significantly as patients change from supine to prone position. Specifically, prone position is associated with greater risk of transpleural puncture on either side, greater distance to the liver for right upper pole puncture, less puncture distance for right lower pole puncture, and possibly greater risk of transcolonic puncture during left lower pole access. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e730 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.Metrics Author Information Brian Eisner Boston, MA More articles by this author Kevin McLaughlin Boston, MA More articles by this author Kim Stein Boston, MA More articles by this author Naveen Kulkarni Boston, MA More articles by this author Dushyant Sahani Boston, MA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ..." @default.
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- W1984867266 title "1819 RENAL AND PERIRENAL ANATOMY IN THE SUPINE AND PRONE POSITION: IMPLICATIONS FOR PERCUTANEOUS STONE TREATMENT" @default.
- W1984867266 doi "https://doi.org/10.1016/j.juro.2011.02.1838" @default.
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