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Prone Lateral Minimally Invasive Retropleural Corpectomy Using a Rotatable Radiolucent Jackson Table
Published on: July 3, 2025
Should PCNL patients have a CT in the prone position preoperatively?
Venu Chalasani1, Darren Bissoon, Ashok K Bhuvanagir
1Department of Urology, NHS Lanarkshire, United Kingdom.
The Canadian Journal of Urology
|April 20, 2010
Summary
Female patients have a higher risk of colonic injury during lower pole percutaneous nephrostomy (PCNL). Preoperative imaging can identify patients with retrorenal colon, enabling technique adjustments to minimize risks during PCNL procedures.
Area of Science:
- Urology
- Radiology
- Surgical Anatomy
Background:
- Lower pole percutaneous nephrostomy is a common procedure for percutaneous nephrolithotomy (PCNL).
- Various imaging modalities like fluoroscopy, CT, and ultrasound are used for guidance.
- The risk of colonic injury during this procedure necessitates understanding renal-colonic relationships.
Purpose of the Study:
- To estimate the risk of colonic injury during lower pole percutaneous nephrostomy for PCNL.
- To determine the prevalence of the colon lying posterior to the kidney (retrorenal) in patients undergoing CT examinations.
Main Methods:
- Retrospective analysis of 134 patients who underwent CT kidney, ureter, bladder (KUB) examinations.
- Assessment of the colon's position relative to the kidney in the prone position.
Main Results:
- The prevalence of a retrorenal colon was observed in 13.6% of males (right) and 11.9% (left).
- In females, the prevalence of a retrorenal colon was 13.4% (right) and significantly higher at 26.2% (left).
Conclusions:
- Female patients, particularly on the left side, exhibit a higher prevalence of retrorenal colon.
- Preoperative imaging is recommended for high-risk patients to identify retrorenal colon.
- Identifying retrorenal colon allows for modifications in surgical technique, such as using ultrasound or CT guidance, to prevent colonic injury.
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