SciELO - Scientific Electronic Library Online

 
vol.68 número6PROP1 overexpression in corticotrophinomas: evidence for the role of PROP1 in the maintenance of cells committed to corticotrophic differentiation índice de autoresíndice de assuntospesquisa de artigos
Home Pagelista alfabética de periódicos  

Serviços Personalizados

Journal

Artigo

Indicadores

Links relacionados

Compartilhar


Clinics

versão impressa ISSN 1807-5932

Resumo

GUGLIELMETTI, Giuliano B. et al. Predicting calyceal access for percutaneous nephrolithotomy with computed tomography multiplanar reconstruction. Clinics [online]. 2013, vol.68, n.6, pp.892-895. ISSN 1807-5932.  http://dx.doi.org/10.6061/clinics/2013(06)27.

OBJECTIVES:

Objective parameters in computed tomography (CT) scans that could predict calyceal access during percutaneous nephrolithotomy have not been evaluated. These parameters could improve access planning for percutaneous nephrolithotomy. We aimed to determine which parameters extracted from a preoperative multiplanar reconstructed CT could predict renal calyceal access during a percutaneous nephrolithotomy.

METHODS:

From January 2009 through April 2011, 230 patients underwent 284 percutaneous nephrolithotomies at our institution. Sixteen patients presented with complete staghorn calculi, and 11 patients (13 renal units) were analyzed. Five parameters were extracted from a preoperative reconstructed CT and compared with the surgical results of percutaneous nephrolithotomy.

RESULTS:

Fifty-eight calyces were studied, with an average of 4.4 calyces per procedure. A rigid nephroscope was used to access a particular calyx, and a univariate analysis showed that the entrance calyx had a smaller length (2.7 vs. 3.98 cm, p = 0.018). The particular calyx to be accessed should have a smaller length (2.22 vs. 3.19 cm, p = 0.012), larger angles (117.6 vs. 67.96, p<0.001) and larger infundibula (0.86 vs. 0.61 cm, p = 0.002). In the multivariate analysis, the only independent predictive factor for accessing a particular calyx was the angle between the entrance calyx and the calyx to be reached (OR 1.15, 95% confidence interval [CI], 1.053-1.256, p = 0.002).

CONCLUSION:

The angle between calyces obtained by multiplanar CT reconstruction is the only predictor of calyx access.

Palavras-chave : Computed Tomography; Kidney; Percutaneous Nephrolithotomy; Urinary Calculi.

        · texto em Inglês     · Inglês ( pdf )