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01-06-2010 | Original Article

A radiological investigation of the hepatorenal space: the importance of the ventral decubitus for safer percutaneous right renal access

Authors: Manoel Antonio Gonçalves Pombo, Luciana da Silva Pombo, Bernardo De-Ary-Pires, Mário Ary Pires-Neto, Ricardo de Ary-Pires

Published in: Anatomical Science International | Issue 2/2010

Abstract

We investigated anatomical and radiological morphometric parameters, aiming to minimize the risk of hepatic and colonic injuries during right percutaneous kidney access under either ventral or dorsal decubitus of patients. Prone and supine abdominal computerized tomographic examinations from 31 normal adult volunteers (men = 12; women = 19; without history of abdominal pathology) were analyzed morphometrically in order to study the dynamic anatomical relations between the liver and the right kidney. The age of the volunteers ranged from 22 to 64 years old (mean ± SD = 42.77 ± 2.10). We observed a significantly greater distance between the liver and the right kidney (hepatorenal space) when the examinee is positioned in ventral decubitus (3.93 ± 0.37 cm) in comparison with dorsal decubitus (1.98 ± 0.20 cm). Accordingly, we conclude that right percutaneous access to the inferior right renal pole implies a significantly lower risk (P < 0.01) of both hepatic and biliary injuries when performed in ventral decubitus, comparatively to dorsal decubitus.

Chen RN, Moore RG, Micali S, Kavoussi LR (1997) Retroperitoneoscopic renal biopsy in extremely obese patients. Urology 50:195–198CrossRefPubMed

Cunningham D (1949) Anatomia Humana. Marin, Barcelona

Desai MR, Kukreja RA, Desai MM et al (2004) A prospective randomized comparison of type of nephrostomy drainage following percutaneous nephrostolithotomy: large bore versus small bore versus tubeless. J Urol 172:565–567CrossRefPubMed

Drake RL, Vogl W, Mitchell AWM (2005) Gray’s Anatomy for students. Elsevier, Cleveland

Ellis H (2006) Clinical Anatomy applied for students and junior doctors. Blackwell, Oxford

Fernstrom I, Johansson B (1976) Percutaneous pyelolithotomy. A new extraction technique. Scand J Urol Nephrol 10:257–259PubMed

Fisher MB, Bianco FJ Jr, Carlin AM, Triest JA (2004) Biliary peritonitis complicating percutaneous nephrolithomy requiring laparoscopic cholecystectomy. J Urol 171:791–792CrossRefPubMed

Goodwin WE, Casey WC, Woolf W (1955) Percutaneous trocar (needle) nephrostomy in hydronephrosis. J Am Med Assoc 157:891–894PubMed

Hadar H, Gadoth N (1984) Positional relations of colon and kidney determined by perirenal fat. AJR Am J Roentgenol 143:773–776PubMed

Hernandez DJ, Sinkov VA, Roberts WW et al (2001) Measurement of bio-impedance with a smart needle to confirm percutaneous kidney access. J Urol 166:1520–1523CrossRefPubMed

Hopper KD, Sherman JL, Luethke JM, Ghaed N (1987) The retrorenal colon in the supine and prone patient. Radiology 162:443–446PubMed

Manaligod JR, Pirani CL (1985) Renal biopsy in 1985. Semin Nephrol 5:237–239PubMed

Matlaga BR, Shah OD, Zagoria RJ, Dyer RB, Streem SB, Assimos DG (2003) Computerized tomography guided access for percutaneous nephrostolithotomy. J Urol 170:45–47CrossRefPubMed

Moore KL, Dalley AF (1999) Clinically oriented Anatomy. Lippincott Williams and Wilkins, New York

Prassopoulos P, Gourtsoyiannis N, Cavouras D, Pantelidis N (1990) A study of the variation of colonic positioning in the pararenal space as shown by computed tomography. Eur J Radiol 10:44–47CrossRefPubMed

Preminger GM, Schultz S, Clayman RV, Curry T, Redman HC, Peters PC (1987) Cephalad renal movement during percutaneous nephrostolithotomy. J Urol 137:623–625PubMed

Ramchandani P, Cardella JF, Grassi CJ et al (2003) Quality improvement guidelines for percutaneous nephrostomy. J Vasc Interv Radiol 14:S277–S281PubMed

Rouviere H (1956) Anatomia humana descriptiva y topografica. Bailly-Bailliere, Madrid

Saad WE, Virdee S, Davies MG et al (2006) Inadvertent discontinuation of percutaneous nephrostomy catheters in adult native kidneys: incidence and percutaneous management. J Vasc Interv Radiol 17:1457–1464CrossRefPubMed

Sampaio FJ, Aragao AH (1990) Anatomical relationship between the intrarenal arteries and the kidney collecting system. J Urol 143:679–681PubMed

Sampaio FJ, Zanier JF, Aragao AH, Favorito LA (1992) Intrarenal access: 3-dimensional anatomical study. J Urol 148:1769–1773PubMed

Testut L, Latarjet A (1977) Tratado de Anatomia Humana. Salvat, Barcelona

Valdivia Uria JG, Valle Gerhold J, Lopez Lopez JA et al (1998) Technique and complications of percutaneous nephroscopy: experience with 557 patients in the supine position. J Urol 160:1975–1978CrossRefPubMed

Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA (2007) Campbell-Walsh urology. Saunders, New York

Wickre CG, Golper TA (1982) Complications of percutaneous needle biopsy of the kidney. Am J Nephrol 2:173–178CrossRefPubMed

Williams PL, Bannister LH, Collins P, Ellis H (1995) Gray’s anatomy. Churchil Livingstone, New York

Zagoria RJ, Dyer RB (1999) Do’s and don’t’s of percutaneous nephrostomy. Acad Radiol 6:370–377CrossRefPubMed

Title: A radiological investigation of the hepatorenal space: the importance of the ventral decubitus for safer percutaneous right renal access
Authors: Manoel Antonio Gonçalves Pombo
Luciana da Silva Pombo
Bernardo De-Ary-Pires
Mário Ary Pires-Neto
Ricardo de Ary-Pires
Publication date: 01-06-2010
Publisher: Springer Japan
Published in: Anatomical Science International / Issue 2/2010
Print ISSN: 1447-6959
Electronic ISSN: 1447-073X
DOI: https://doi.org/10.1007/s12565-009-0057-7

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A radiological investigation of the hepatorenal space: the importance of the ventral decubitus for safer percutaneous right renal access

Abstract

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Abstract

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