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All Journal e-CliniC Medical Scope Journal (MSJ) International Journal of Health and Pharmaceutical (IJHP)
Wihono, Frendy
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Nursing Public Health

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Journal : e-CliniC

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First Endoscopic-Guided Percutaneous Nephrolithotomy (ePSL) with Prone Split-Leg Position in Manado Phoebus, Andrien; Astram, Ari; Toreh, Christof; Arianto, Eko; Wihono, Frendy
e-CliniC Vol. 13 No. 1 (2025): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v13i1.59320

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Abstract: Literature has not yet defined the best position for percutaneous nephrolithotomy (PCNL) based on the complexity of the stone burden. This case of left-sided complex kidney stones underwent endoscopic-guided PCNL in an PSL (prone split-leg position). A 61-year-old woman with a chief complaint of right pelvic pain. Standard prone PCNL was planned for this patient, however, due to so much debris in the pelviocalyceal system during URS evaluation and ureter catheter insertion, we decided to puncture with ultrasound guidance rather than fluoroscopy. Intraoperatively there was residual superior calyx stone that was beyond the reach of nephroscope. We decided not to do a double puncture because of poor vision due to the floating debris. In the second procedure, the ePSL method was utilized. A C-arm and nephroscope examination revealed no active bleeding, no infundibulum laceration, and no remaining stones. The primary goals of this method were to remove stones from the urinary tract throughout the entire tract using a one-step, one-access procedure that made the most of the full range of endourologic equipment. There were a number of reasons why the prone split-leg position was chosen, including operator preference, familiarity with the position, and the inability to make a direct puncture in the upper pole. The main drawback was that patient would not be able to see how well and safely this method worked over time. In conclusion, complex kidney stones can be treated with ePSL performed in the prone split-leg position, which is a safe procedure with a low risk of complications. Keywords: percutaneous nephrolithotomy; prone split-leg position; complex kidney stones
Long-Term Follow-up after Kidney Trauma at Prof. Dr. R. D. Kandou General Hospital Manado Arianto, Eko; Panelewen, Bryan P.; Astram, Ari; Toreh, Christof; Wihono, Frendy
e-CliniC Vol. 13 No. 2 (2025): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v13i2.59605

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Abstract: Renal trauma, caused by blunt or penetrating injuries, is associated with severe complications such as hypertension, chronic kidney disease (CKD), and pyelonephritis, especially in high-grade renal trauma. The study aimed to evaluate the complications and management of renal trauma patients at Prof. Dr. R. D. Kandou Hospital Manado from January 2022 to October 2024. This was an observational study with a cross-sectional design involving 17 patients that met the inclusion criteria. Data included types of trauma, severity level, management approaches, and post-trauma complications. Trauma severity was classified using the American Association for Surgery of Trauma (AAST) grading system. The results showed that 58.8% of patients had penetrating trauma, while 41.2% experienced blunt trauma. The highest percentages were found in grade II severity (29.4%). Operative management was the most common approach (58.8%). Post-trauma complications included CKD (70.5%), hypertension (29.4%), and pyelonephritis (29.4%). In conclusion, renal trauma, whether blunt or penetrating, often leads to significant complications such as CKD and hypertension. Proper long-term management and monitoring of kidney function and blood pressure are crucial to minimize the complications. This study highlights the need for early and effective intervention in high-grade renal trauma cases. Keywords: renal trauma; hypertension; acute kidney injury (AKI); chronic kidney disease (CKD); post-trauma complications
Co-Authors Ari Astram, Ari ARIANTO, EKO Hardianti Kusanto, Putri Krishna, Mahesa Panelewen, Bryan P. Phoebus, Andrien R. Torry, Stivano Toreh, Christof