The use of anatomical landmarks for percutaneous nephrolithotomy
Küçük Resim Yok
Tarih
2012
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Çalışmamızda prone pozisyonunda uygulanan perkütan nefrolitotomide dış gösterge ve açıların tanımlanması amaçlanmıştır. Gereç ve Yöntem: Çalışmaya alınma kriterlerine uygun 50 (10 asistan vakası dahil) hasta 2006-2008 arasında çalışmaya dahil edildi. Çalışmaya alınma kriterleri, alt kalikse 3 ve daha az girişimde başarılı olunması ve iğneden berrak idrar gelmesi; dışlanma kriterleri ise aynı taraftan geçirilmiş operasyon, ciddi hidronefroz, böbrek veya iskelet anomalileri, obezite, orta-üst kaliks girişimi gerektiren hastalar ve 18 yaşından küçük hastalar olarak belirlendi. Çeşitli anatomik göstergeler ölçülüp değerlendirildi. Bulgular: Anatomik göstergelerden ortalama değerler şu şekilde saptandı; (Pi) 10.1±1.7 cm (7-14), (Pe) 9.9±1.7 cm (6-13), (a) 11.2±2.8 cm (5.5-17), (b) 5.3±2.3 cm (1.5-11 cm), (x) 5.1±1.9 cm (1-8), (x1) 3.3±1.7 cm (1.5-8.2), (y) 7.1±1.7 cm (3.3-11.6), (y1) 3.8±1.6 cm (1-9) ve (t) 4.9±1.7 cm (3-9). Anatomik açıların değerleri ise; (?) 49±13º (30-70º), (?) 41±13º (20-70º) ve (?) 61±13º (28-80º) olarak ölçüldü. Asistan vakalarınde en çok deneme 1 kez (1-3), başarılı giriş denemesi için geçen sure 7.25 dakika (2-12 dk.) ve skopi süresi ise 62.5 saniye (30-150 sn.) olarak saptandı. Sonuç: Anatomik gösterge ve açıların bilinmesi, ürologların perkütan nefrolitotomide alt kaliks girişlerini daha başarılı şekilde yapmasını sağlayabilir.
Objective: the aim of our study was to describe the external anatomical landmarks and angles as a training guide for urologists in the performance of percutaneous nephrolithotomy (PCNL) in the prone position. Materials and Methods: Between 2006 and 2008, 50 patients (including 10 resident cases) undergoing PCNL met the study criteria. the inclusion criteria consisted of patients with renal stones scheduled for a lower calyceal puncture PCNL where the number of attempts to access the calyx ≤ 3, and clear urine was seen draining from the needle. the exclusion criteria consisted of previous ipsilateral kidney surgery, severe hydronephrosis, anomalies of the renal or skeletal systems, BMI>30 kg/m2, upper/middle calyceal puncture and age ≤18. Several anatomical landmarks and angles were measured, recorded and analyzed. Results: the mean length of (Pi) was 10.1±1.7 cm (range 7-14), (Pe ) was 9.9±1.7 cm (range 6-13), (a) was 11.2±2.8 cm (range 5.5-17), (b) was 5.3±2.3 cm (range 1.5-11 cm), (x) was 5.1±1.9 cm (range 1-8), (x1) was 3.3±1.7 cm (range 1.5-8.2), (y) was 7.1±1.7 cm (range 3.3-11.6), (y1) was 3.8±1.6 cm (range 1-9) and (t) was 4.9±1.7 cm (range 3-9). the mean angle for (a) was 49±13º (range 30-70º), (b) was 41±13º (range 20-70º) and (g) was 61±13º (range 28-80º). in resident cases, the median number of attempts was 1 (range 1-3), the median overall time for successful access was 7.25 minutes (range 2-12) and the median fl uoroscopy time was 62.5 seconds (range 30-150). Conclusion: A knowledge of these anatomical landmarks and angles may increase the capacity of urologists to repetitively perform the precise task of percutaneous access of the lower calyceal during PCNL.
Objective: the aim of our study was to describe the external anatomical landmarks and angles as a training guide for urologists in the performance of percutaneous nephrolithotomy (PCNL) in the prone position. Materials and Methods: Between 2006 and 2008, 50 patients (including 10 resident cases) undergoing PCNL met the study criteria. the inclusion criteria consisted of patients with renal stones scheduled for a lower calyceal puncture PCNL where the number of attempts to access the calyx ≤ 3, and clear urine was seen draining from the needle. the exclusion criteria consisted of previous ipsilateral kidney surgery, severe hydronephrosis, anomalies of the renal or skeletal systems, BMI>30 kg/m2, upper/middle calyceal puncture and age ≤18. Several anatomical landmarks and angles were measured, recorded and analyzed. Results: the mean length of (Pi) was 10.1±1.7 cm (range 7-14), (Pe ) was 9.9±1.7 cm (range 6-13), (a) was 11.2±2.8 cm (range 5.5-17), (b) was 5.3±2.3 cm (range 1.5-11 cm), (x) was 5.1±1.9 cm (range 1-8), (x1) was 3.3±1.7 cm (range 1.5-8.2), (y) was 7.1±1.7 cm (range 3.3-11.6), (y1) was 3.8±1.6 cm (range 1-9) and (t) was 4.9±1.7 cm (range 3-9). the mean angle for (a) was 49±13º (range 30-70º), (b) was 41±13º (range 20-70º) and (g) was 61±13º (range 28-80º). in resident cases, the median number of attempts was 1 (range 1-3), the median overall time for successful access was 7.25 minutes (range 2-12) and the median fl uoroscopy time was 62.5 seconds (range 30-150). Conclusion: A knowledge of these anatomical landmarks and angles may increase the capacity of urologists to repetitively perform the precise task of percutaneous access of the lower calyceal during PCNL.
Açıklama
Anahtar Kelimeler
Üroloji ve Nefroloji
Kaynak
Türk Üroloji Dergisi/Turkish Journal of Urology
WoS Q Değeri
Scopus Q Değeri
Cilt
38
Sayı
2
