The incidence and management of pleural injuries occurring during open nephrectomy.
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.
Atmaca
Ali Fuat
AF
Department of 1st Urology, Ankara Ataturk Training and Research Hospital, 06800 Ankara, Turkey. alifuatatmaca@yahoo.com
Canda
Abdullah Erdem
AE
Serefoglu
Ege Can
EC
Altinova
Serkan
S
Ozdemir
Ahmet Tunc
AT
Balbay
M Derya
MD