Incidence of posterolateral and retrorenal colon in supine and prone position in percutaneous nephrolithotomy

Abstract

Colon injury is a distressing complication during percutaneous nephrolithotomy (PCNL). Posterolateral colon (PLC) and retrorenal colon (RRC) are known to be the risk factors of colonic injury during PCNL. We evaluated the incidence of PLC and RRC in both supine and prone position of patients who underwent PCNL in our institution, and determined the risk factors of PLC and RRC through a review of computed tomography (CT) scan. To define PLC and RRC, we divided kidney into anterior, anterolateral, posterolateral and retrorenal zone by drawing three parallel lines in the CT scan. Among a total of 102 patients, PLC and RRC were identified in 16 (15.7%) cases in supine, and 25 (24.5%) cases in the prone position. PLC and RRC were most frequently present in the upper and lower pole of the left kidney in prone position compared to supine (p value less than 0.001). Risk factors of PLC and RRC in the prone position were old age (over 68), lower body mass index (BMI), and thinner perirenal fat layer. Therefore, an initial percutaneous puncture in PCNL needs to be carefully accessed to those patients with such high risks of colon injury.

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Acknowledgements

We thank Seoul St.Mary's hospital Research center for the support in performing the project.

Funding

This study was supported by Research fund of Seoul St.Mary's hospital, The Catholic university of Korea.

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Correspondence to Hyukjin Cho.

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The authors declare that they have no conflict of interest.

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This study was approved by the Catholic University of Korea Institutional Review Board (IRB) (approval number: KC18RESI0759).

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Not applicable, due to its retrospective study design.

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Hur, K.J., Moon, H.W., Kang, S.M. et al. Incidence of posterolateral and retrorenal colon in supine and prone position in percutaneous nephrolithotomy. Urolithiasis (2021). https://doi.org/10.1007/s00240-021-01272-4

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Keywords

  • Posterolateral colon
  • Prone
  • Percutaneous nephrolithotomy
  • Retrorenal colon
  • Supine