Evaluation of Colon Position in Relation to the Kidney in Supine, Lateral, and Prone Positions by Computed Tomography Scan in Percutaneous Nephrolithotomy Candidates

Abstract

Background and Objective: Nowadays, Percutaneous Nephrolithotomy (PCNL) is popular all over the world and has replaced open surgery for renal and upper ureteral stones. Despite the few complications and less invasiveness of this surgical method, undesirable events, such as damage to the intra-abdominal organs, including the colon, are a constant concern of surgeons. The present study aimed to investigate the position of the colon in relation to the kidney in the lateral, prone, and supine positions in patients who were candidates for PCNL surgery. Materials and Methods: During 12 months, all adult patients who were candidates for PCNL surgery were subjected to computed tomography (CT) scan without contrast in lateral, prone, and supine positions, and the relevant findings related to age, gender, body mass index (BMI), and past surgical history were collected and analyzed. Results: A total of 260 patients, including 129 men and 131 women, were included in the study. The mean age of the patients was 46.95 years (the age range: 21-72). The highest frequency of colon position in prone, semi-supine, complete supine, and lateral positions, respectively, in 122 (49.92%), 186 (71.54%), 169 (65%), and finally 129 (49.62%) patients was anterior to the kidney. In this study, only one case of colon perforation was reported among the 260 patients studied, and the position of the colon was anterior to the kidney in the prone position in that patient. Conclusion: As evidenced by the obtained results, a CT scan without contrast is recommended due to its non-invasiveness to determine the position of the colon, especially in different positions, to minimize iatrogenic complications in PCNL surgery.