OPEN RENAL APPROACH IN PYELOLITHOTOMY: COMPARATIVE ANALYSIS OF SUB-COSTAL INCISION VERSUS TRANS-COSTAL INCISION WITH EXCISION OF 12TH RIB

Dr. Jignesh Damor; Dr. Mukesh Suvera; Dr. Naman Patel; Dr. Sharad Patel; Dr. Gautam Sonagra; Dr. Kena Patel

Volume : V, Issue : I, January - 2016

OPEN RENAL APPROACH IN PYELOLITHOTOMY: COMPARATIVE ANALYSIS OF SUB-COSTAL INCISION VERSUS TRANS-COSTAL INCISION WITH EXCISION OF 12TH RIB

Dr. Jignesh Damor, Dr. Mukesh Suvera, Dr. Naman Patel, Dr. Sharad Patel, Dr. Gautam Sonagra, Dr. Kena Patel

Abstract :

Introduction : Operative renal exposure must be adequate to perform the operation and to deal with any possible complications, because of its deeper location in upper retroperitoneum. Injuries to renal vascular pedicle may be difficult to control or repair through small incisions. Objective: To compare the outcome of sub-costal incision with trans-costal incision & 12th rib resection in the surgical approach for open pyelolithotomy. Methodology: It is a retrospective, analytical, comparative study conducted at Shardaben Hospital. A total of 51 patients were enrolled. Group A, 34 patients, underwent renal surgery via sub-costal incision. Group B, 17 patients, underwent renal surgery via trans-costal incision with excision of 12th rib. Incision time, duration of operation, postoperative pain, duration of hospital stay, & peroperative and postoperative complications were noted. Results: Average Incision time(19.4 min in Group A & 28.9 min in group B) & average duration of operation(84.1 min in Group A and 110.5 min in group B) were longer in group B patients; pain perception(5.5 in Group A and 7.0 in Group B) was also markedly high in B group. Total period to stay in hospital was marginally higher in group B. Peroperative & postoperative complications were also slightly higher in group B patients. Conclusion: Sub-costal renal approach provides adequate exposure, is quick, safe and less painful