[37] Assessment of lower calyceal single-access percutaneous nephrolithotomy (PCNL) for staghorn stones: A single surgeon and a single centre experience at King Abdulaziz Medical City, Riyadh
Objective: To establish whether lower calyceal access percutaneous nephrolithotomy (PCNL) is the safest access and has the same efficacy as upper calyceal access for staghorn stones, as PCNL is still the mainstay treatment of choice for most complex renal stones, but there is still controversy surro...
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| Autores principales: | , |
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| Formato: | article |
| Lenguaje: | EN |
| Publicado: |
Taylor & Francis Group
2018
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| Materias: | |
| Acceso en línea: | https://doaj.org/article/73ef885edd074dc1aefe0900ec6c7e3d |
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| Sumario: | Objective: To establish whether lower calyceal access percutaneous nephrolithotomy (PCNL) is the safest access and has the same efficacy as upper calyceal access for staghorn stones, as PCNL is still the mainstay treatment of choice for most complex renal stones, but there is still controversy surrounding the stone-free rate (SFR) in comparison to upper and middle calyceal accesses. Methods: This is a single surgeon and single tertiary centre retrospective study. All lower calyceal access PCNLs performed from May 2012 to August 2017 were included. To assess the SFR a postoperative computed tomography scan was reviewed. Postoperative complications were reported using the modified Clavien–Dindo Grading System. Descriptive analysis of the data was done. Results: In all, 67 patients were included in our study. The mean hospital stay was 7.9 days and the mean operative time was 138.52 min. The mean staghorn stone burden was 476.34 mm2. Overall, 80.59% (54) of patients had complete stone resolution after the first session and 8.95% (six) of patients required a second session to achieve complete resolution of staghorn stone. Only three patients (4.47%) had complications, classified as Clavien–Dindo Grade II with the remainder classified as Grade I, two patients needed postoperative blood transfusion, one had a renal pelvis perforation, and none had sepsis or a pulmonary embolism. Conclusion: The use of lower calyceal single-access PCNL is safe for treating complex renal stones and achieves stone resolution in one or two sessions in most cases (89.5%), a result that is almost equivalent to the rate achieved by upper calyceal access PCNL in the literature (up to 90%). |
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