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Air embolism during percutaneous nephrolithotomy using air pyelogram during initial access: Does it really occur?
Anshul Garg1, Mohd Mubashir Ali Khan1, Praveen Singh1
1Department of Urology, Uttar Pradesh University of Medical Sciences, Etawah, Uttar Pradesh, India.
Urology Annals
|February 5, 2020
Summary
Using air to visualize the pelvicalyceal system (PCS) during percutaneous nephrolithotomy (PCNL) is safe. This study found no air embolism complications in 164 patients, making air a viable alternative to contrast dye.
Area of Science:
- Urology
- Minimally Invasive Surgery
Background:
- Percutaneous nephrolithotomy (PCNL) is standard for large renal stones (>2 cm).
- Opacifying the pelvicalyceal system (PCS) is crucial before tract dilation.
- Iodinated contrast and air are used, with rare reports of air embolism with air pyelogram.
Purpose of the Study:
- To evaluate the safety and efficacy of using air for PCS opacification during PCNL.
- To assess the incidence of air embolism when using air for initial tract access.
Main Methods:
- Prospective observational study.
- 164 patients undergoing PCNL.
- Air used to opacify PCS via ureteric catheter for initial access.
Main Results:
- No patients experienced complications attributable to air embolism.
- Zero incidence of air embolism during or after the procedure.
Conclusions:
- Air is a safe and acceptable alternative to iodinated contrast for PCS opacification in PCNL.
- The study supports the use of air for initial puncture access in PCNL procedures.
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