Prospective randomized comparison between superior calyceal access versus inferior calyceal access in PCNL for inferior calyceal stones with or without pelvic stones

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• 作者：Vishwajeet Singh ; Yogesh Garg ; Kuldeep Sharma ; Rahul Janak Sinha…
• 关键词：Superior calyceal access ; Inferior calyceal access ; Percutaneous nephrolithotomy ; Inferior calyceal calculi
• 刊名：Urological Research
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：44
• 期：2
• 页码：161-165
• 全文大小：375 KB
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• 作者单位：Vishwajeet Singh (1)
  Yogesh Garg (1)
  Kuldeep Sharma (1)
  Rahul Janak Sinha (1)
  Saurabh Gupta (1)
  
  1. Department of Urology, King George’s Medical University, Lucknow, 226003, Uttar Pradesh, India
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Urology and Andrology
  Nephrology
  Medical Biochemistry
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1434-0879

文摘

The objective of this study is to assess the efficacy of superior calyceal access versus inferior calyceal access for inferior calyceal calculi with or without pelvic calculi. A total of 100 patients with inferior calyceal calculi or inferior calyceal calculi with pelvic calculi were included in this prospective randomized study. In 50 patients (Group 1), a fluoroscopy-assisted superior calyceal puncture was made, and in other 50 patients (Group 2), access was obtained through a fluoroscopy-assisted inferior calyceal puncture. The stone-free rates, hemoglobin drop, operative duration, requirement for additional tracts, complications, and auxiliary procedures in the two groups were compared. Stone clearance rates and hemoglobin drop values were better in group 1, though they were not statistically significant. The mean operative duration, number of tracts required, and the relook procedure rate were significantly in favor of Group 1. Only one patient (2 %) in Group 1 developed hydropneumothorax related to supracostal puncture and required intercostal tube drainage. Superior calyceal puncture (supracostal or infracostal) provides favorable access to inferior calyceal stones, providing better and faster clearance with less requirement of secondary tracts and auxiliary procedures.