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International Expert Consensus and Recommendations for Neonatal Pneumothorax Ultrasound Diagnosis and Ultrasound-guided Thoracentesis Procedure
Published on: March 12, 2020
Delayed pneumothorax after tubeless percutaneous nephrolithotomy
Yeong-Chin Jou1, Ming-Chin Cheng, Cheng-Huang Shen
1Department of Urology, Chiayi Christian Hospital, Chiayi, Taiwan.
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
|December 1, 2007
Summary
Delayed pneumothorax can occur after tubeless percutaneous nephrolithotomy for staghorn stones, even when using the optimal supracostal approach. This case highlights a rare complication requiring attention in post-operative monitoring.
Area of Science:
- Urology
- Nephrology
- Thoracic Surgery
Background:
- Percutaneous nephrolithotomy (PCNL) is standard for large and staghorn stones.
- Supracostal PCNL offers a direct tract for staghorn calculi but risks pleural injury.
- Pneumothorax is a known, usually immediate, complication of PCNL.
Observation:
- A patient developed delayed pneumothorax after tubeless PCNL for a complete staghorn stone.
- The supracostal approach was utilized, aiming for optimal renal access.
- Symptoms of pneumothorax manifested post-operatively, not immediately after the procedure.
Findings:
- Delayed pneumothorax is a potential, albeit uncommon, complication of supracostal PCNL.
- Tubeless PCNL does not eliminate the risk of delayed respiratory complications.
- The precise mechanism for delayed pneumothorax in this context requires further investigation.
Implications:
- Clinicians should maintain a high index of suspicion for delayed pneumothorax in patients undergoing supracostal PCNL.
- Extended post-operative observation may be warranted for patients with specific risk factors.
- This case underscores the importance of comprehensive patient monitoring following minimally invasive urological procedures.
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