Comparative evaluation of upper versus lower calyceal approach in percutaneous nephrolithotomy (PCNL) for managing renal calculi

Objective: To compare upper versus lower calyceal approaches in percutaneous nephrolithotomy for managing renal calculi. Method: The retrospective study was conducted in the Department of Urology, The Kidney Centre Post-Graduate Training Institute, Karachi, and comprised data of patients who underwent percutaneous nephrolithotomy from January 2014 to January 2015. Patients were divided into upper pole puncture group A and lower pole puncture group B. Data was analysed using SPSS 17. Results: Of the 198 patients, 147(74.2%) were males and 51(25.8%) were females. The overall mean age was 40.64±14.02 years. Of the total, 69(34.84%) were in group A and 129(65.15%) were in group B. Inter-group difference was significant in pre- and post-operative haemoglobin (p<0.05). Post-operative outcomes showed that blood transfusion, stone clearance and complication like tube thoracostomy had significant association with both the groups (p<0.05). Complete clearance was seen in 152(76.8%) patients; 40(74.1%) in group A and 102(81.6%) in group B. Conclusion: The success rate was found to be better in lower calyceal puncture group than upper calyceal puncture group for the management of renal calculi.