title: The incidence and management of pleural injuries occurring during open nephrectomy.
abstract: OBJECTIVE
  To evaluate the incidence, management, and risk factors of pleural injuries occurring during open nephrectomy.
  
  
  METHODS
  Between June 2004/and June 2008, 165 patients (167 renal units) underwent open simple (n = 37, 22.2%), partial (n = 39, 23.4%) or radical (n = 91, 54.5%) nephrectomy in our institution.
  
  
  RESULTS
  Flank, Chevron, and abdominal midline incisions were used in 148(88.6%), 17(10.2%), and in 2(1.2%) surgical procedures, respectively. Ribs were excised in 109(65.3%) procedures (11th rib, 10th-11th ribs, and 11th-12th ribs). Intraoperative pleural injuries were detected in 20(12%) procedures, 16(80%) were treated successfully with simple evacuation technique, and 4 required chest tube insertion. Age, sex, surgery type, incision type, and surgery site were not associated with pleural injury occurrence (P > .05). Rib resection was the only parameter associated with pleural injury occurrence.
  
  
  CONCLUSIONS
  Pleural injuries occur in 12% of open nephrectomy procedures, and 80% can be repaired successfully. Few of them (2.4%) need chest tube insertion. Performing rib resection is a significant risk factor for pleural injury occurrence during nephrectomies.
authors.affiliation: Department of 1st Urology, Ankara Ataturk Training and Research Hospital, 06800 Ankara, Turkey. alifuatatmaca@yahoo.com
authors.forename: Ali Fuat
authors.initials: AF
authors.lastname: Atmaca
authors.forename: Abdullah Erdem
authors.initials: AE
authors.lastname: Canda
authors.forename: Ege Can
authors.initials: EC
authors.lastname: Serefoglu
authors.forename: Serkan
authors.initials: S
authors.lastname: Altinova
authors.forename: Ahmet Tunc
authors.initials: AT
authors.lastname: Ozdemir
authors.forename: M Derya
authors.initials: MD
authors.lastname: Balbay