Introduction & Objectives
\nMini-percutaneous nephrolithotomy (miniPCNL) shows comparable efficacy to conventional caliber for stones < 2 cm, reducing risks;however, there is scarce evidence regarding intercostal access in the supine position. The objective of our work is to compare uppercalyx (UC) renal access vs. lower calyx (LC) in supine miniPCNL.
\nMaterials & Methods
\nA descriptive, anonymized and aggregated analysis was performed on patients treated with supine miniPCNL from September 2012to December 2024. Population was divided into two groups: LC in Group 1, UC in Group 2 (all intercostal access). Primary outcomewas stone-free rate (SFR), established as residual fragments \u2264 3 mm (assessed by non-contrast CT scan 2 months after surgery).Complications were classified according to the PCNL- specific Clavien-Dindo (CD) score. Frequencies with percentages were usedfor qualitative variables and means with standard deviations for quantitative variables. Comparisons between groups for quantitativevariables were performed using the independent samples t-Test or the Mann-Whitney U test. This study was approved by theClinical Research Ethics Committee of Valladolid (CEIm, PI-24-519-H).
\nResults
\nA total of 108 patients were included: 56 in Group 1 and 52 in Group 2. Previous history of urolithiasis was higher in Group 2 (35patients; 67.3%). Group 2 showed greater variability in the treated stone\u00b4s location compared to Group 1, as well as in the possibilityof indirect stone treatment (38.5% of cases involved proximal ureter and lower calyx stones). Mean stone size was 18 mm in Group1 and 22 mm in Group 2, besides 8.9% and 23.5% stones were staghorn in the respective groups. Regarding intercostal cases inGroup 2, 33 were supra-12th rib and 19 supra-11th rib. No intraoperative complications were registered. Embolization was requiredin one case per group, one admission to the ICU due to hypovolemic shock in Group 1. No postoperative nephrostomy was placedin 94.6% of Group 1 nor in 94.2% of Group 2. SFR in both groups was: 84.9% in Group 1 and 85.1% in Group 2 (p = 0.978)
\nConclusions
\nEffectiveness and safety are comparable between intercostal access to the superior calyx and access to the inferior calyx duringsupine miniPCNL.<\/p>","protected":false},"excerpt":{"rendered":"
Introduction & Objectives Mini-percutaneous nephrolithotomy (miniPCNL) shows comparable efficacy to conventional caliber for stones < 2 cm, reducing risks;however, there is scarce evidence regarding intercostal access in the supine position. The objective of our work is to compare uppercalyx (UC) … read more<\/a><\/p>","protected":false},"author":3,"featured_media":183,"menu_order":0,"template":"","meta":{"_acf_changed":false},"portfolio-type":[19],"portfolio-tag":[],"class_list":["post-182","portfolio","type-portfolio","status-publish","has-post-thumbnail","hentry","portfolio-type-unmoderated-posters"],"acf":[],"_links":{"self":[{"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/portfolio\/182","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/portfolio"}],"about":[{"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/types\/portfolio"}],"author":[{"embeddable":true,"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/users\/3"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/media\/183"}],"wp:attachment":[{"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/media?parent=182"}],"wp:term":[{"taxonomy":"portfolio-type","embeddable":true,"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/portfolio-type?post=182"},{"taxonomy":"portfolio-tag","embeddable":true,"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/portfolio-tag?post=182"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}