Pleurotomy, pneumothorax, and surveillance during living donor nephroureterectomy.
OBJECTIVE
To determine the incidence of and risk factors associated with pneumothorax after donor nephroureterectomy and to determine the utility of postoperative chest roentgenography.


METHODS
A retrospective review was made of 130 living donor nephroureterectomies performed at one institution (Yale-New Haven Hospital) using an extraperitoneal flank incision.


RESULTS
Incidental pleurotomy occurred in 11 cases (8.5%). Rib resection was associated with pleurotomy. Patient age, sex, and side of operation were not associated with pleurotomy. Ten (91 %) of the 11 cases were identified intraoperatively. One unrecognized pneumothorax was identified postoperatively with chest roentgenography; no specific intervention was necessary.


CONCLUSIONS
The extraperitoneal flank incision poses a significant risk for pneumothorax. Most pneumothoraces will be recognized intraoperatively. No adverse effects were noted secondary to pneumothorax.
Department of Surgery, Yale-New Haven Hospital, Connecticut, USA.
L E
LE
Olsson
H
H
Swana
A L
AL
Friedman
M I
MI
Lorber
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D015994:Incidence; D007431:Intraoperative Complications / Q000453:epidemiology*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D009392:Nephrectomy; D010994:Pleura / Q000293:injuries*; D011030:Pneumothorax / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D014513:Ureter / Q000601:surgery*