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Advances in Urology
Volume 2009, Article ID 948906, 4 pages
Clinical Study

The Incidence and Management of Pleural Injuries Occurring during Open Nephrectomy

Department of 1st Urology, Ankara Ataturk Training and Research Hospital, 06800 Ankara, Turkey

Received 13 May 2009; Revised 13 May 2009; Accepted 8 July 2009

Academic Editor: Douglas S. Scherr

Copyright © 2009 Ali Fuat Atmaca et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


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 ( %), partial ( %) or radical ( %) 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 ( ). Rib resection was the only parameter associated with pleural injury occurrence. Conclusion. 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.