| RE:
STEERABLE ANTEGRADE STENTING: A NEW TRICK OF THE TRADE
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UDO NAGELE, ARISTOTELIS
G. ANASTASIADIS, BASTIAN AMEND, DAVID SCHILLING, MARCUS KUCZYK, ARNULF
STEND, KARL-DIETRICH SIEVERT
Departament
of Urology, University of Tuebingen, Germanye
Int
Braz J Urol, 33: 389-394, 2007
To the Editor:
The
authors describe as a novelty the percutaneous kidney punction with the
patient placed in supine position to carry out in an antegrade way the
ureteral stenting (1). However we described this procedure 20 years ago
(2), in a work that was published in many important urological journal
such as the Journal of Urology (3), the Journal of Endourology (4) and
the Brazilian Journal of Urology (5) among others.
Among the advantages demonstrated by the
percutaneous kidney approach with patient in supine position, (which have
been referenced in our previous communications) the possibility exists
of simultaneously performing combined endoluminal instrumentation, which
can even carry out with a rigid transuretral ureterorrenoscopy at the
same time as a percutaneous nephroscopy. This fact has been recently highlighted
by many authors, notably including Ibarlucea et al. (6) and Scarpa &
Scoffone (7).
In contrast to the opinion of the authors
of this paper and of Park (8) who made the first editorial comment to
this process, we can confirm that with the patient in supine position
does not result in the essential sonographic control in order to perform
the percutaneous punction of the kidney. We only make use the sonographically
guided renal puncture in extreme circumstances. In the majority of instances
we carry out the punction under a simple radioscopic control in P-A, without
having to change the position of the C arm which is precisely one of the
multiple advantages of this procedure.
Liatsikos & Voudoukis (9), who make
the second editorial comment attribute the origin of the combined technique
(called “Redezvous Technique”) to Marci et al. (10), who described
it for the ureteral stenting in 2005. Nevertheless, in our work published
in the Journal of Endourology in 1990 (4) we already showed a radiological
image with a face to face in to the kidney of a percutaneous nephroscope
and a rigid transurethral ureterorenoscope, when referenced the advantages
of working both, radiologically and edoscopically, simultaneously from
both fields.
REFERENCES
1. Nagele U, Anastasiadis AG, Amend B, Schilling D, Kuczyk
M, Stenzl A, Sievert KD: Steerable antegrade stenting: A new trick of
the trade. Int Braz J Urol. 2007; 33: 389-94.
2. Valdivia-Uría JG, Lanchares E, Villarroya S: Nefrolitectomía
percutánea: Técnica simplificada (nota previa). Arch Esp
Urol. 1987; 40: 177.
3. Valdivia-Uría JG, Valle Gerhold J, López JA: Technique
and complications of percutaneous nephroscopy: experience with 557 patients
in supine position. J Urol. 1998; 160: 1975-8.
4. Valdivia-Uría JG, Valer J, Villarroya S: Why is percutaneous
nephroscopy still performed with patient prone? J Endourol. 1990; 4: 350-9.
5. Valdivia-Uría JG, Valle J, López JA: Técnica de
la nefroscopia percutánea en posición supina. J Bras Urol.
1999; 25: 263-7.
6. Ibarlucea G, Scoffone C M, Cracco C M: Supine Valdivia and modified
lithotomy position for simultaneous anterograde and retrograde endourological
access. BJU Int. 2007; 100: 233-6.
7. Scarpa RM, Scoffone CM: Galdakao-modified supine Valdivia lithotomy
position for endoscopic combined intra renal surgery (ECIRS). Multilingual
DVD presentation. Karl Storz Endoskope. Tuttlingen. Endopress 2007.
8. Park S: Editorial Comment in: Steerable antegrade stenting: A new trick
of the trade. Int Braz J Urol. 2007; 33: 393-4.
9. Liatsikos EN, Voudoukis TH: Editorial Comment in: Steerable antegrade
stenting: A new trick of the trade. Int Braz J Urol. 2007; 33: 394.
10. Macri A, Magno C, Certo A: Combined antegrade and retrograde ureteral
stenting: The rendezvous technique. Clin Radiol. 2005; 60: 457-60.
Dr.
José Gabriel Valdivia Uría
Departament of Urology
Universitary Hospital Lozano Blesa
Saragossa, Spain
E-mail: jvaldivia@salud.aragon.es
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