CHANGING KIDNEY POSITION IN PATIENTS ON THE OPERATING TABLE - VALDIVIA AND VALDIVIA GALDAKAO
Abstract
Purpose. To compare the changes of the kidney position in patient posed on the back in Valdivia and Galdakao-modified supine Valdivia (GMSV) in order to select the optimal direction for puncture of the targeted kidney calix.
Material and methods. The study was conducted on 30 people. All patients underwent non-contrast and contrast urography.
Results. The total average distance between the calix and the puncture point in different positions was 96.1 (±18.7 mm) on the back versus 103.7 (±23.2 mm) on the GMSV (p<0.04). There was a decrease in thickness in the GMSV position of the right kidney> < 0.04). There was a decrease in thickness in the GMSV position of the right kidney in the area of upper calix, middle calix, lower clix by 4.6, 5.9, 7.4 mm (respectively); on the left kidney by 0.8, 1.1, 3.6 mm (respectively). There was a decrease in the angle in the axial projection relative to the horizontal in the right kidney in upper, middle, lower calices by 12.5°, 7.4°, 8.1° (respectively); in the left kidney by 4.2°, 7.5°, 15.7° (respectively).
An increase in the length of access to the calix, a decrease in the thickness of the kidney during patient’s rotation were determined. The angle of access became sharper in the side position. The changes in kidney was insignificant in the GMSV position and percutaneous nephrolithotripsy was still possible.
Conclusion. CT urography allows to determine the accuracy and safety of puncture of the targeted calix. Reduced thickness of the kidney in the GMSV position suggests a reduction in potential kidney injury. A slight displacement of the kidney in the GMSV position allows it to be widely recommended for PNL.
About the Authors
M. M. Kutluev
Медицинский Центр «Консультант» OOO «Медрейд»
Russian Federation
Russian Federation
N. A. Grigoriev
АО «Европейский медицинский центр»;
ЧУ ДПО «Медицинская школа EMC»
Russian Federation
Russian Federation
R. I. Safiullin
ФГБУ «Национальный медицинский исследовательский центр акушерства,
гинекологии и перинатологии имени академика В.И. Кулакова»
Russian Federation
Russian Federation
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Review
For citations:
Kutluev M.M., Grigoriev N.A., Safiullin R.I. CHANGING KIDNEY POSITION IN PATIENTS ON THE OPERATING TABLE - VALDIVIA AND VALDIVIA GALDAKAO. Bashkortostan Medical Journal. 2024;19(3):10-15. (In Russ.)
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