THE PREVALENCE OF RETRORENAL COLON AMONG COMPUTERIZED TOMOGRAPHY SCANNED PATIENTS

  • ABDULGHAFOOR S. ABDULKAREEM Assistant Prof, Department of the Surgery, College of Medicine, University of Duhok, Kurdistan Region, Iraq
  • SALEEM K. MUSALAH Department of the Surgery, College of Medicine, University of Duhok, Kurdistan Region, Iraq.
  • ASAAD S. OMAR Department of the Surgery, College of Medicine, University of Duhok, Kurdistan Region, Iraq.
Keywords: Colon injury, Retrorenal colon, Percutaneous nephrolithotomy

Abstract

https://doi.org/10.31386/dmj.2021.15.1.1

Background: percutaneous nephrolithotomy (PCNL) is regarded as the treatment of choice for most renal stones larger than 2cm. Colon injury is one of the rare and preventable complications during PCNL. The rare and unusual location of the colon behind the kidney (retrorenal colon) is an anatomical predisposing factor and other factors that can result in colon perforation during PCNL.

Aim: To evaluate the prevalence of retrorenal and posterolateral colon and among CT scanned patients.

Patients and methods: one thousand CT scanned patients of all ages and both sexes were included and their CT images were evaluated prospectively at the CT scan center at Azadi Teaching Hospital for the presence of retrorenal colon and the relation of the colon to different parts of the kidney.

Results: In this study, 1000 CT scanned patients of different ages and both sexes were included. There were 522 males and 478 females; their ages ranged from 6 to 85 years. The overall prevalence of retrorenal colon was 7.5% (6.3% in males and 8.7% in females). The prevalence of retro renal colon according to different ages was:  at below 10 y was 16%, 11-20 years 8.3%, 21-30 y 5.9 %, 31-40 y 7.2 %, 41-50y 7.2%, 51-60y 11.2%, 61-70y 5.8% 71-80y 7.2% and at 81-90 y was 9%, and the differences regarding the ages and sexes were statistically not significant. The lower pole of the left kidney is the most common part involved by the retrorenal colon in 70.6%, while the right lowers pole by 12%, the left middle part by 10.6%, and bilateral lower poles by 6.6%.

Conclusion: Locally, the prevalence of retrorenal colon is within the usual range with no sex or age predominance, and a pre-operative abdominal CT scan (native one) is a diagnostic one and is essential if left lower renal calyx is planned to be targeted to avoid colonic injury.

 

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References

1. Patel SR, Nakada SY. The Modern History and Evolution of Percutaneous Nephrolithotomy. J Endourol. 2015;29 (2):153-7. https://doi.org/10.1089/end.2014.0287
2. Michel MS, Trojan L, Rassweiler JJ. Complications in percutaneous nephrolithotomy. Eur Urol. 2007;51(4):899–906. https://doi.org/10.1016/j.eururo.2006.10.020
3. Zare MA, Darabi MR, Shakiba B, Mahtaj LG. Colonic perforation during percutaneous nephrolithotomy: An 18-year experience. CUAJ. 2014;8(5-6):323–6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4039595/
4. El-Nahas, A.R., Shokeir, A.A., El-Assmy, A.M., Shoma, A.M., Eraky, I., El-Kenawy, M.R., El-Kappany, H.A., Colonic perforation during percutaneous nephrolithotomy: study of risk factors. Urology. 2006; 67(5):937–941. https://doi.org/10.1016/j.urology.2005.11.025
5. Daughtry JD, Rodan BA, Bean WJ. Avoiding Bowel Perforation During Percutaneous Nephrolithotomy in Patients with Renal Anomalies. J Endourol. 1987;1(3):173-6. https://www.liebertpub.com/doi/10.1089/end.1987.1.173
6. Gadzhiev N, Malkhasyan V, Akopyan G, Petrov S, Jefferson F, Okhunov Z. Percutaneous nephrolithotomy for staghorn calculi: Troubleshooting and managing complications. Asian J Urol. 2019;7(2):139-48. https://www.sciencedirect.com/science/article/pii/S2214388219301031
7. Öztürk H.Treatment of Colonic Injury During Percutaneous Nephrolithotomy. Rev Urol. 2015;17(3):194–201. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4633665/
8. Marchini GS, Berto FC, Vicentini FC, Shan CJ, Srougi M, Mazzucchi E. Preoperative Planning with Noncontrast Computed Tomography in the Prone and Supine Position for Percutaneous Nephrolithotomy: A Practical Overview. J Endour. 2015;29(1) https://doi.org/10.1089/end.2014.0299
9. Boon JM, Shinners B, Meiring JH. Variations of the position of the colon as applied to percutaneous nephrostomy. Surg Radiol Anat. 2002;23:421–5. https://link.springer.com/article/10.1007/s00276-001-0421-3
10. Hopper KD, Sherman JL, Luethke JM, Ghaed N. The retrorenal colon in the supine and prone patient. Radiology. 1987;162(2):443–6. https://doi.org/10.1148/radiology.162.2.3797658
11. Stefanos K, Athanasios P, Christian B, Stylianos K, Faruquz Zaman F, et al. Colon perforation during percutaneous renal surgery: a 10-year experience in a single endourology centre. Urol Res. 2012; 40,263–8. https://doi.org/10.1007/s00240-012-0464-4
12. Balasar M, Kandemir A, Poyraz N, Unal Y, Ozturk A. Incidence of retrorenal colon during percutaneous nephrolithotomy. Int Braz J Urol. 2015; 41(2):274–8.
https://www.intbrazjurol.com.br/pdf/vol4050/Vol41_n2_2015.pdf#page=90
13. Lojanapiwat B. The ideal puncture approach for PCNL: Fluoroscopy, ultrasound or endoscopy? Indian J Urol. 2013;29(3):208–13. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3783701/
14. Agrawal MS, Agarwal K, Jindal T, Sharma M. Ultra-mini-percutaneous nephrolithotomy: A minimally-invasive option for percutaneous stone removal. Indian J Urol. 2016;32(2):132–6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4831502/
15. Hadar H, Gadoth N. Positional relations of colon and kidney determined by perirenal fat. AJR. 1984;143(4):773–6. https://www.ajronline.org/doi/abs/10.2214/ajr.143.4.773
16. Balasar M, Kandemir A, Poyraz N, Unal Y, Ozturk A. Incidence of retrorenal colon during percutaneous nephrolithotomy. Int Braz J Urol. 2015;41(2):274-8. https://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382015000200274
17. Sharma G1, Jangid DK, Yadav SS, Mathur R, Tomar V. Retro-renal colon: role in percutaneous access. Urolithiasis. 2015;43(2):171-5. https://www.ncbi.nlm.nih.gov/pubmed/25344467
18. Sherman JL, Hopper KD, Green AJ, Johns TT. The retrorenal colon on computed tomography: a normal variant. J Comput Assist Tomogr. 1985;9(2):339-41. https://journals.lww.com/jcat/toc/1985/03000
19. Faure JP, Richer P, Chansigaud JP, Scepi M, Irani J,FerrieJC, Kamina P. A prospective radiological anatomical study of the variations of the position of the colon in the left pararenal space. Surg Rad Anat. 2001;23(5):335-6. https://link.springer.com/article/10.1007/s00276-001-0335-0
20. Wu P., Wang L., Wang K. Supine versus prone position in percutaneous nephrolithotomy for kidney calculi: a meta-analysis. Int Urol Nephro. 2011;43(1):67–77. https://link.springer.com/article/10.1007/s11255-010-9801-0
21. Nour HH, Kamal AM, Ghobashi SE, Zayed AS, Rushdy MM, El-Baz AG, Kamel AI, El-Leithy T. Percutaneous nephrolithotomy in the supine position: Safety and outcomes in a single-centre experienceHani. Arab J Urol. 2013;11(1):62–7. http://europepmc.org/article/PMC/4442971
Published
2021-04-27
How to Cite
S. ABDULKAREEM, A., K. MUSALAH, S., & S. OMAR, A. (2021). THE PREVALENCE OF RETRORENAL COLON AMONG COMPUTERIZED TOMOGRAPHY SCANNED PATIENTS. Duhok Medical Journal, 15(1), 1-10. Retrieved from https://dmj.uod.ac/index.php/dmj/article/view/142