Safety and efficacy of superior calyceal access versus inferior calyceal access for pelvic and/or lower calyceal renal calculi- A prospective observational comparative study

dc.authorid0000-0002-6308-1763
dc.authorid0000-0003-0906-4417
dc.contributor.authorAmaresh, M.
dc.contributor.authorHegde, P.
dc.contributor.authorChawla, A.
dc.contributor.authorde la Rosette, Jean J. M. C. H.
dc.contributor.authordel Pilar Laguna Pes, Maria
dc.contributor.authorKriplani, A.
dc.date.accessioned2021-11-03T07:20:54Z
dc.date.available2021-11-03T07:20:54Z
dc.date.issued2021
dc.departmentİstanbul Medipol Üniversitesi, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Üroloji Ana Bilim Dalı
dc.departmentİstanbul Medipol Üniversitesi, Uluslararası Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Üroloji Ana Bilim Dalı
dc.description.abstractObjective: To compare efficacy and safety between superior calyceal access and inferior calyceal access for pelvic and/or lower calyceal renal stones. Methods: Consecutive patients presenting with Pelvic and/or inferior calyceal renal calculi were allocated to the superior calyceal access (group 1) or inferior calyceal access (group 2) treatment arm. Allocation of treatment access was based on the surgeon's preference. Variables studied included stone free rate, operating time, intraoperative and postoperative complications. Statistical analysis was executed using SPSS, Version 16.0. The statistical significance was evaluated at 5% level of significance (p value < 0.05). Results: Between July 2018 and February 2019, 63 patients were included in each group. The percutaneous inserted guidewire entered the ureter in 92% in group1 and 74.6% in group 2 (p = 0.034). Stone fragments migrated to the middle calyx in 3.2% in group1 and 9.5% in group 2 (p = 0.033). A second puncture was required in one patient in group 1 and in 5 patients in group 2 (p = 0.04). The operative duration (minutes) was 13.46 ± 1.09 in the group 1 while 16.58 ± 1.44 in the group 2 (p = 0.002). Thoracic complications (hydropneumothorax) occurred to 2 patients in superior calyceal access group managed with intercostal tube drainage (p = 0.243).Post operatively blood transfusion was required in two patients in group 2 (p = 0.169). Angioembolization was done in one patient among the inferior calyceal access approach (p = 0.683). Complete stone clearance assessed at 3 months was 96.8% in group 1 and 85.7% in group 2 (p = 0.046). Conclusions: Superior calyceal access is a safe and most efficacious in terms of achieving complete stone clearance rate with reduced operative time, minimal blood loss, less need for a second puncture and auxiliary procedures at minimal complications.
dc.identifier.citationAmaresh, M., Hegde, P., Chawla, A., de la Rosette, J. J. M. C. H., del Pilar Laguna Pes, M. ve Kriplani, A. (2021). Safety and efficacy of superior calyceal access versus inferior calyceal access for pelvic and/or lower calyceal renal calculi- A prospective observational comparative study. World Journal of Urology, 39(6), 2155-2161. https://dx.doi.org/10.1007/s00345-020-03409-3
dc.identifier.doi10.1007/s00345-020-03409-3
dc.identifier.endpage2161
dc.identifier.issn0724-4983
dc.identifier.issn1433-8726
dc.identifier.issue6
dc.identifier.scopusqualityQ1
dc.identifier.startpage2155
dc.identifier.urihttps://dx.doi.org/10.1007/s00345-020-03409-3
dc.identifier.urihttps://hdl.handle.net/20.500.12511/8549
dc.identifier.volume39
dc.identifier.wosqualityQ1
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherSpringer
dc.relation.ispartofWorld Journal of Urologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsAttribution 4.0 International*
dc.rightsinfo:eu-repo/semantics/openAccess
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/*
dc.subjectPCNL
dc.subjectRenal
dc.subjectCalculi
dc.subjectPercutaneous Nephrolithotomy
dc.subjectSuperior Calyx
dc.subjectInferior Calyx
dc.subjectAccess
dc.titleSafety and efficacy of superior calyceal access versus inferior calyceal access for pelvic and/or lower calyceal renal calculi- A prospective observational comparative study
dc.typeArticle

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