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Anatomical variation between the prone, supine, and supine oblique positions on computed tomography: implications for percutaneous nephrolithotomy access.

Abstract：

OBJECTIVE:To determine anatomical variations between the prone, supine, and supine oblique positions that are likely to affect percutaneous renal access. MATERIAL AND METHODS:Twenty patients underwent computed tomography urograms in the supine and prone positions. Twenty patients underwent supine oblique and prone scans. Mean nephrostomy tract length, maximum access angle, and anterior-posterior renal position were calculated. RESULTS:Mean nephrostomy tract length was shorter in the prone position (82.6 mm right kidney, 85.4 mm left kidney) compared with the supine position (108.3 mm right kidney, P<.001; 103.7 mm left kidney, P<.001). Prone tract length was also shorter than supine oblique tract length (86.1 mm vs 96.5 mm; P=.048). Mean maximum access angle was significantly greater (P=.018 right kidney; P=.007 left kidney) in the prone position (right kidney 99.7°, left kidney 104.0°) compared with the supine position (right kidney 87.7°, left kidney 89.4°). The same was true for the prone compared with the supine oblique position (75.8° vs 58.7°; P=.004). No difference was noted in anterior-posterior renal position between the supine and prone positions (20.3 mm vs 26.7 mm; P=.094) or supine oblique and prone positions (22.8 mm vs 15.6 mm; P=.45). CONCLUSIONS:The prone position is associated with a significantly shorter nephrostomy tract length and more potential access sites, which may improve ease and safety of percutaneous renal access.

journal_name

Urology

journal_title

Urology

authors

Duty B,Waingankar N,Okhunov Z,Ben Levi E,Smith A,Okeke Z

doi

10.1016/j.urology.2011.06.019

subject

Has Abstract

pub_date

2012-01-01 00:00:00

pages

67-71

issue

1

eissn

0090-4295

issn

1527-9995

pii

S0090-4295(11)00633-9

journal_volume

79

pub_type

杂志文章

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