You have accessJournal of UrologyStone Disease: New Technology/SWL, Ureteroscopic or Percutaneous Stone Removal1 Apr 20111944 IS ROUTINE POST-OPERATIVE CHEST X-RAY NEEDED AFTER PERCUTANEOUS NEPHROLITHOTOMY? Marc Bjurlin, Michael Jordan, Naveen Divakaruni, Jed Robinson, Lindsey Lombardo, Sandra Goble, Patricia Vidal, Traci Beck, and Courtney Hollowell Marc BjurlinMarc Bjurlin Chicago, IL More articles by this author , Michael JordanMichael Jordan Chicago, IL More articles by this author , Naveen DivakaruniNaveen Divakaruni Chicago, IL More articles by this author , Jed RobinsonJed Robinson Chicago, IL More articles by this author , Lindsey LombardoLindsey Lombardo Chicago, IL More articles by this author , Sandra GobleSandra Goble Chicago, IL More articles by this author , Patricia VidalPatricia Vidal Chicago, IL More articles by this author , Traci BeckTraci Beck Chicago, IL More articles by this author , and Courtney HollowellCourtney Hollowell Chicago, IL More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.2125AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To assess whether routine postoperative chest radiography (CXR) is required after percutaneous nephrolithotomy (PCNL) for the detection and possible management of a pneumothorax. It has become the standard of care by many urologists to obtain routine postoperative CXRs after open nephrectomy to assess for the presence of a pneumothorax. However, at our institution, very few patients have developed a pneumothorax postoperatively, and, furthermore, the CXR findings almost never affected the clinical management. METHODS A retrospective review of 214 PCNL's acquired from 2004 to 2010. Data analyzed included patient demographics, operative data, postoperative CXR findings, and complications. RESULTS We retrospective reviewed 214 PCNL's, 50% were male, with a mean age of 48 years, and mean stone burden was 2.4 x 2.5 cm. Renal access was obtained by the urologists in 43%. Upper pole renal access was obtained in 50%, mid-pole in 26%, and lower pole in 22% through the 11–12th intercostals space in 46% and below the 12th rib in 53%. Renal access was unsuccessful in 2.8%. All patients underwent a postoperative CXR. Only two patients (1%) had a pneumothorax of which one patient's CXR findings were normal immediately after surgery. One patient was managed with a chest tube, the other with a percutaneous thoracic drain. Most common complications included anemia (6%), tachycardia (6%), and sepsis (1.4%). Mean hospital length of stay was 1.6 days and mortality was 0.5%. CONCLUSIONS Routine postoperative CXRs are not needed after PCNL. Obtaining a selective CXR when a recognized intraoperative pnumothorax has occurred, the physical examination reveals an abnormality, or the patient experiences respiratory difficulties in the postoperative period is safe, cost-effective, and decreases the radiation exposure to patients. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e777 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Marc Bjurlin Chicago, IL More articles by this author Michael Jordan Chicago, IL More articles by this author Naveen Divakaruni Chicago, IL More articles by this author Jed Robinson Chicago, IL More articles by this author Lindsey Lombardo Chicago, IL More articles by this author Sandra Goble Chicago, IL More articles by this author Patricia Vidal Chicago, IL More articles by this author Traci Beck Chicago, IL More articles by this author Courtney Hollowell Chicago, IL More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
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