Comparative evaluation of upper versus lower calyceal approach in percutaneous nephrolithotomy (PCNL) for managing...

To compare upper versus lower calyceal approaches in percutaneous nephrolithotomy for managing renal calculi.

The retrospective study was conducted in the Department of Urology, The Kidney Centre Post-Graduate Training Institute, Karachi, and comprised data of patients who underwent percutaneous nephrolithotomy from January 2014 to January 2015. Patients were divided into upper pole puncture group A and lower pole puncture group B. Data was analysed using SPSS 17.

Of the 198 patients, 147(74.2%) were males and 51(25.8%) were females. The overall mean age was 40.64±14.02 years. Of the total, 69(34.84%) were in group A and 129(65.15%) were in group B. Inter-group difference was significant in pre- and post-operative haemoglobin (p<0.05). Post-operative outcomes showed that blood transfusion, stone clearance and complication like tube thoracostomy had significant association with both the groups (p<0.05). Complete clearance was seen in 152(76.8%) patients; 40(74.1%) in group A and 102(81.6%) in group B.

The success rate was found to be better in lower calyceal puncture group than upper calyceal puncture group for the management of renal calculi.