International Journal of General Medicine (Nov 2022)

Prevalence of the Retro-Renal Colon: A Systematic Review and Meta-Analysis with Implications for Percutaneous Nephrolithotomy

  • Kipkorir V,
  • Cheruiyot I,
  • Ongidi I,
  • Nyaanga FK,
  • Neema B,
  • Otieno EH,
  • Baskaran RR,
  • Srichawla BS,
  • Biswas J,
  • Dhali GK,
  • Dhali A

Journal volume & issue
Vol. Volume 15
pp. 8275 – 8283

Abstract

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Vincent Kipkorir,1 Isaac Cheruiyot,1 Ibsen Ongidi,1 Fiona K Nyaanga,1 Bridget Neema,1 Elisha Harry Otieno,1 Roger R Baskaran,2 Bahadar S Srichawla,3 Jyotirmoy Biswas,4 Gopal Krishna Dhali,5 Arkadeep Dhali6 1Department of Human Anatomy and Physiology, College of Health Sciences, University of Nairobi, Nairobi, Kenya; 2Department of Critical Care, St. John’s Medical College, Bangalore, India; 3Department of Neurology, UMass Chan Medical School, Worcester, MA, USA; 4Department of General Medicine, College of Medicine and Sagore Dutta Hospital, Kolkata, India; 5Department of Gastroenterology, Institute of Postgraduate Medical Education and Research, Kolkata, India; 6Department of Internal Medicine, Nottingham University Hospitals NHS Trust, Nottingham, UKCorrespondence: Arkadeep Dhali; Roger R Baskaran, Email [email protected]; [email protected]: This systematic review and meta-analysis aims to determine the prevalence of the retrorenal colon (RRC) and its implications in percutaneous nephrolithotomy with the overall objective of promoting the prevention of associated iatrogenic complications.Methods: A systematic search of literature was conducted on the electronic databases PubMed, ScienceDirect, and Hinari to identify studies eligible for inclusion. Search results were screened by title and abstract, and those potentially relevant were evaluated by full text. Studies were deemed eligible for inclusion if they reported clear extractable data regarding the prevalence of the retro-renal colon. A meta-analysis was completed using MetaX1 to calculate the pooled prevalence of the retro-renal colon. Sub-group analysis was performed based on geographical regions from which the studies originated, imaging modality, and patient position.Results: 174 records were screened and a total of 10 records included in the analysis with retrospective cohort studies being the most common study design. A male predominance was seen in most sample sizes that had reported data on gender demographics ranging from 41.5– 62%. The most common imaging modality utilized was computerized tomography (CT) scan followed by ultrasound. The range of the unweighted prevalence of retro-renal colon across all studies that had absolute numbers reported was from 3.5– 25%. One of the studies reported a colonic perforation rate of 0.3% in patients without CT images.Conclusion: The retro-renal colon is a relatively common finding with observed preponderance to females and left lateralization. The presence of RRC increases the likelihood of colon perforations while gaining percutaneous access to the kidney. Pre-procedural imaging can help detect its presence and choose an appropriate route of entry. USG and CT have both been found useful as a modality to pick up RRC.Keywords: colon, nephrolithotomy, retro-renal, urolithiasis

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