Evaluating upper versus lower calyceal access in percutaneous nephrolithotomy: a prospective comparative study in complex renal calculi

Navneet Mishra; Ashish Kumar Singh; M. Chandra Vamsi Krishna; Umesh Gautam; Manoj Kumar Mishra

doi:10.18203/2320-6012.ijrms20253176

Authors

Navneet Mishra Hind Institute of Medical Sciences, Barabanki, India
Ashish Kumar Singh Hind Institute of Medical Sciences, Barabanki, India
M. Chandra Vamsi Krishna Hind Institute of Medical Sciences, Barabanki, India
Umesh Gautam Hind Institute of Medical Sciences, Barabanki, India
Manoj Kumar Mishra Hind Institute of Medical Sciences, Barabanki, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20253176

Keywords:

Percutaneous nephrolithotomy, Endourology, Lower calyceal access, Upper calyceal access, Renal calculi, Stone clearance

Abstract

Background: Percutaneous nephrolithotomy (PCNL) is the preferred modality for managing complex renal calculi, yet the optimal calyceal access upper or lower remains debated due to varied outcomes and complication profiles.

Methods: The research included 100 patients undergoing PCNL for treatment of complex renal stones. A division of patients occurred into two distinct groups: those accessing the upper calyces with n=46 and those accessing the lower calyces with n=54. Medical staff evaluated stone size together with operative time and haemoglobin drop and stone clearance and hospital stay duration.

Results: Finding shows operative durations (84.35 min vs. 84.66 min, p>0.05), baseline stone sizes (39.07 mm vs. 39.41 mm, p>0.05), haemoglobin decline (1.58 vs. 1.57 gm%, p>0.05) and hospital stay (3.80 vs. 3.67 days, p>0.05) were similar for both groups. Though the variation was not statistically noteworthy (p>0.05), the upper calyceal group (86.96%) had a greater total stone clearance rate than the lower (75.93%).

Conclusions: Regarding operative time, safety and recuperation, upper and lower calyceal access in PCNL produced similar clinical results. Upper calyceal access, on the other hand, indicated a tendency toward improved stone clearance, implying possible clinical preference in certain complicated situations.

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