Abstract:
OBJECTIVE: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. STUDY REGISTRATION:Clinical trials registry - INDIA; CTRI/2018/07/014,687.
journal_name
World J Uroljournal_title
World journal of urologyauthors
Amaresh M,Hegde P,Chawla A,de la Rosette JJMCH,Laguna MP,Kriplani Adoi
10.1007/s00345-020-03409-3subject
Has Abstractpub_date
2020-08-31 00:00:00eissn
0724-4983issn
1433-8726pii
10.1007/s00345-020-03409-3pub_type
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journal_title:World journal of urology
pub_type: 杂志文章,多中心研究
doi:10.1007/s00345-018-2290-y
更新日期:2018-09-01 00:00:00
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journal_title:World journal of urology
pub_type: 杂志文章
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journal_title:World journal of urology
pub_type: 杂志文章
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journal_title:World journal of urology
pub_type: 杂志文章,评审
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journal_title:World journal of urology
pub_type: 杂志文章
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pub_type: 杂志文章,meta分析,多中心研究
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pub_type: 杂志文章
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pub_type: 临床试验,杂志文章
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pub_type: 杂志文章
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journal_title:World journal of urology
pub_type: 杂志文章
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pub_type: 杂志文章,评审
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更新日期:2004-04-01 00:00:00
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journal_title:World journal of urology
pub_type: 杂志文章
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更新日期:2018-08-01 00:00:00
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journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/BF00182064
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pub_type: 杂志文章,多中心研究
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pub_type: 杂志文章
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journal_title:World journal of urology
pub_type: 杂志文章,评审
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pub_type: 杂志文章,评审
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更新日期:2018-04-01 00:00:00
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journal_title:World journal of urology
pub_type: 临床试验,杂志文章
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journal_title:World journal of urology
pub_type: 杂志文章
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pub_type: 杂志文章,评审
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journal_title:World journal of urology
pub_type: 杂志文章,评审
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更新日期:2018-12-01 00:00:00
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journal_title:World journal of urology
pub_type: 杂志文章,评审
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更新日期:2019-03-01 00:00:00
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pub_type: 杂志文章
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更新日期:2020-10-20 00:00:00