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Upper‐pole puncture in percutaneous nephrolithotomy: a retrospective review of treatment safety and efficacy
Author(s) -
Raza Asif,
Moussa Sami,
Smith Gordon,
Tolley David A.
Publication year - 2008
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2007.07388.x
Subject(s) - medicine , percutaneous nephrolithotomy , surgery , complication , percutaneous
OBJECTIVE To review the safety and efficacy of supracostal puncture during percutaneous nephrolithotomy (PCNL) for renal calculi. PATIENTS AND METHODS Over a 12‐year period, 66 patients had either an upper‐pole puncture alone or combined with middle‐ or lower‐pole puncture during PCNL for renal calculi. All punctures were made by an experienced uroradiologist and were either supra‐ or subcostal. We retrospectively reviewed all case notes and radiographs to determine stone‐clearance rates and complications associated with the site and number of punctures. RESULTS There was an overall stone‐free rate of 78% with upper‐pole puncture alone or combined with middle‐ or lower‐pole puncture. There was a 3% thoracic complication rate with upper pole punctures, and an overall complication rate of 30% for both thoracic and non‐thoracic complications. CONCLUSION Upper‐pole puncture in PCNL is associated with minimum morbidity if done by an experienced urologist or radiologist. The stone‐free rate appears to be more dependent on stone size and complexity than the site of puncture.