Abstract

Background: Branched stones called staghorn calculi make up most of the pelvicalyceal system. For staghorn calculi, percutaneous nephrolithotomy (PCNL) is currently the recommended first-line treatment option. Optimal renal access is critical to PCNL success. Objective: to compare between lower and upper calyceal PCNL approaches for treating staghorn calculus at the renal pelvis and/or lower calyx. Methods: PCNL was performed on 40 patients with complex renal stones in our center. Twenty had a lower calyceal puncture, and 20 had upper calyceal access. The two methods are compared in terms of the overall duration of the procedure, the requirement for a second puncture, the success rate (residual stone presence), intraoperative blood transfusion rates, postoperative complication rates, and hospital stay. Results: The mean operative time in lower access was 64.5±23.73 min which was longer than that of upper group (50.5±18.88 min) with a significant. Compared to none in the upper calyceal approach, five patients (20%) in the lower approach require a secondary puncture. Two patients (10%) in the upper access experienced pneumothorax versus one patient (2%) in the lower access experienced angioembolization. There is no difference in the duration of hospital stays between the two methods. Conclusion: The upper calyceal approach, with minimizes lung complications and requires a short surgical time, is a feasible option for pelvic and/or lower calyceal renal calculi.

Keywords

The article was added to IASJ on 2024-10-14

0 Total full text downloads since the date of addition