Upper, middle, and lower CALYX accesses for prone percutaneous nephrolithotomy: a comparative study.

Area of Science:

• Urology
• Nephrology
• Surgical Techniques

Background:

• Percutaneous nephrolithotomy (PCNL) is a key procedure for kidney stone removal.
• Optimizing access points within the kidney calyx is crucial for PCNL success.
• Comparative data on upper, middle, and lower calyceal access in prone PCNL is limited.

Purpose of the Study:

• To compare the efficacy of upper, middle, and lower calyceal accesses during prone percutaneous nephrolithotomy.
• To evaluate stone-free rates, residual stone burden, hemoglobin drop, and fluoroscopic time across different calyceal access groups.

Main Methods:

• A prospective comparative clinical study involving 151 patients with renal stones.
• Patients were divided into three groups based on calyceal access: upper (G1), mid (G2), and lower (G3).
• Key procedural parameters and post-operative outcomes were analyzed and compared between groups.

Main Results:

• No statistically significant differences were observed in stone-free rates among the three calyceal access groups (G1: 71.4%, G2: 57.9%, G3: 74%).
• The mean hemoglobin drop was comparable across all groups, indicating similar blood loss.
• Stone size ranged from 20-60mm, with no significant impact on outcomes based on access site.

Conclusions:

• Upper, middle, and lower calyceal accesses for prone PCNL demonstrate comparable outcomes regarding residual stone rates and hemoglobin drop.
• The choice of calyceal access does not appear to significantly influence the success or complications of PCNL in this study.
• Further research may explore other factors influencing PCNL outcomes.