title: The role of percutaneous nephrolithotomy in the management of medium-sized (1-2 cm) lower-pole renal calculi.
abstract: OBJECTIVE
  The objective of this study was to determine the efficacy (defined by stone-free rates) and safety of percutaneous nephrolithotomy (PNL) in the treatment of medium sized (1-2 cm) symptomatic lower pole renal calculi, and establishment of the short-term morbidity.
  
  
  METHODS
  We performed a retrospective analysis of 60 evaluable patients who had undergone PNL for 1 to 2 cm diameter lower-pole (LP) stones between November 2006 to March 2009 and compared these results with other treatment modalities in published literature.
  
  
  RESULTS
  In all cases, stones were located in the lower calix. Thirty-six procedures were performed on the left side, and 24 were performed on the right side. The mean time to access the collecting system was 20.4 minutes (range 8-70 min) and mean operative time was 62.2 minutes (range 13-155 min). Abdominal radiography performed on postoperative day 1 demonstrated a stone free status in 56 (93.3%) patients. However, 4 patients (6.7%) required ancillary procedures (secondary PNL in 1, retrograde intrarenal surgery in 1, and SWL in 2). After this secondary procedures a complete stone-free status was achieved in 98.3% of patients. The morbidity of patients undergoing PNL at our hospital was minimal, with a mean hospital stay of 3.7 days.
  
  
  CONCLUSIONS
  We demonstrated that, PNL is a safe and effective method for medium sized (1 to 2 cm) lower pole renal calculi and percutaneous removal should be considered the primary approach for lower pole stones greater than 10 mm.
authors.affiliation: Kecioren Training and Research Hospital, Department of Urology, Ankara, Turkey.
authors.forename: A
authors.initials: A
authors.lastname: Unsal
authors.forename: B
authors.initials: B
authors.lastname: Resorlu
authors.forename: C
authors.initials: C
authors.lastname: Kara
authors.forename: M
authors.initials: M
authors.lastname: Bayindir
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000601:surgery*; D007670:Kidney Calices; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous; D013812:Therapeutics; D055815:Young Adult