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Conference Paper: PCNL trajectory to predict success in supine PCNL: a novel concept

TitlePCNL trajectory to predict success in supine PCNL: a novel concept
Authors
KeywordsMedical sciences
Urology and nephrology
Issue Date2011
PublisherMary Ann Liebert, Inc Publishers. The Journal's web site is located at http://www.liebertpub.com/end
Citation
The 29th World Congress of Endourology & SWL WCE, Kyoto, Japan, 30 November–3 December 2011. In Journal of Endourology, v. 25 suppl 1, p. A145, abstract no. MP23-13 How to Cite?
AbstractINTRODUCTION: Supine PCNL confers certain advantages over prone. Access parameters change with positioning. Supine position limits maneuverability of instruments, limiting access to upper & mid-pole stones. We aim to determine predictive factors for success of supine PCNL through road-mapping of PCNL trajectory. MATERIAL & METHOD: Consecutive patients undergoing PCNL from July-Dec2010 were recruited. Choice of position was made by surgeon. Tracts were performed under USG & fluoroscopy. Distances and angles were measured intra-operatively with rigid and flexible nephroscope, and correlated with pre-operative imaging. RESULTS 19 patients underwent PCNL(13supine, 6prone) Stone load was comparable in both groups. Overall stone clearance after single PCNL was 74%. Regardless of abdominal thickness and approach, all lower pole and renal pelvic stones were reached with mean excursion of 140 mm in supine & 105 mm in prone position. Mean entry angle was 59 for supine, and 35 for prone. In supine PCNL, the upper pole was reached in 4 of 11 tracts, with mean-excursion of 172mm& entry angle of 33. Similarly, 2 of 11 supine PCNL reached middle pole. Conversely, all prone PCNL tracts reached upper & middle pole with decreased excursion & angle. CONCLUSION: PCNL in prone position can reach renal pelvis and 3 poles via lower pole puncture. PCNL trajectory may be a tool to predict success in supine PCNL by estimating chance of reaching mid & upper pole. Skin to upper pole distance larger than 185mm and entry angle more than 48 degrees decrease chance of upper pole access.
DescriptionThis journal suppl. contatin program & abstracts of the 29th World Congress of Endourology & SWL WCE, 2011
Session - MP23: PNL 2: abstract no. MP23-13
Persistent Identifierhttp://hdl.handle.net/10722/149265
ISSN
2015 Impact Factor: 2.107
2015 SCImago Journal Rankings: 1.173

 

DC FieldValueLanguage
dc.contributor.authorNg, ATLen_US
dc.contributor.authorFu, KKFen_US
dc.contributor.authorHo, KLen_US
dc.date.accessioned2012-06-22T06:33:19Z-
dc.date.available2012-06-22T06:33:19Z-
dc.date.issued2011en_US
dc.identifier.citationThe 29th World Congress of Endourology & SWL WCE, Kyoto, Japan, 30 November–3 December 2011. In Journal of Endourology, v. 25 suppl 1, p. A145, abstract no. MP23-13en_US
dc.identifier.issn0892-7790en_US
dc.identifier.urihttp://hdl.handle.net/10722/149265-
dc.descriptionThis journal suppl. contatin program & abstracts of the 29th World Congress of Endourology & SWL WCE, 2011en_US
dc.descriptionSession - MP23: PNL 2: abstract no. MP23-13-
dc.description.abstractINTRODUCTION: Supine PCNL confers certain advantages over prone. Access parameters change with positioning. Supine position limits maneuverability of instruments, limiting access to upper & mid-pole stones. We aim to determine predictive factors for success of supine PCNL through road-mapping of PCNL trajectory. MATERIAL & METHOD: Consecutive patients undergoing PCNL from July-Dec2010 were recruited. Choice of position was made by surgeon. Tracts were performed under USG & fluoroscopy. Distances and angles were measured intra-operatively with rigid and flexible nephroscope, and correlated with pre-operative imaging. RESULTS 19 patients underwent PCNL(13supine, 6prone) Stone load was comparable in both groups. Overall stone clearance after single PCNL was 74%. Regardless of abdominal thickness and approach, all lower pole and renal pelvic stones were reached with mean excursion of 140 mm in supine & 105 mm in prone position. Mean entry angle was 59 for supine, and 35 for prone. In supine PCNL, the upper pole was reached in 4 of 11 tracts, with mean-excursion of 172mm& entry angle of 33. Similarly, 2 of 11 supine PCNL reached middle pole. Conversely, all prone PCNL tracts reached upper & middle pole with decreased excursion & angle. CONCLUSION: PCNL in prone position can reach renal pelvis and 3 poles via lower pole puncture. PCNL trajectory may be a tool to predict success in supine PCNL by estimating chance of reaching mid & upper pole. Skin to upper pole distance larger than 185mm and entry angle more than 48 degrees decrease chance of upper pole access.-
dc.languageengen_US
dc.publisherMary Ann Liebert, Inc Publishers. The Journal's web site is located at http://www.liebertpub.com/enden_US
dc.relation.ispartofJournal of Endourologyen_US
dc.rightsCreative Commons: Attribution 3.0 Hong Kong Licenseen_US
dc.subjectMedical sciences-
dc.subjectUrology and nephrology-
dc.titlePCNL trajectory to predict success in supine PCNL: a novel concepten_US
dc.typeConference_Paperen_US
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0892-7790&volume=25&issue=Suppl 1&spage=A145&epage=&date=2011&atitle=PCNL+trajectory+to+predict+success+in+supine+PCNL:+a+novel+concepten_US
dc.identifier.emailHo, KL: hkl218@hkucc.hku.hken_US
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1089/end.2011.2001.supp-
dc.identifier.hkuros200213en_US
dc.identifier.volume25en_US
dc.identifier.issuesuppl 1en_US
dc.identifier.spageA145en_US
dc.identifier.epageA145en_US
dc.publisher.placeUnited States-
dc.description.otherThe 29th World Congress of Endourology & SWL WCE, Kyoto, Japan, 30 November–3 December 2011. In Journal of Endourology, v. 25 suppl 1, p. A145, abstract no. MP23-13-

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