[Percutaneous nephrolithotomy through the upper pole calix access for complicated renal calculi: report of 581 cases].
OBJECTIVE
To discuss the optimal approach of percutaneous nephrolithotomy (PCNL) for treatment of complicated renal calculi.


METHODS
A total of 581 patients with complicated renal calculus were treated by PCNL through the upper pole calix access. Of the 581 patients, 55 had multiple upper pole calculi, 136 had staghorn stones, 145 had partial staghorn stones, and 245 had multiple renal calculi.


RESULTS
PCNL through the upper pole calix access was completed successfully in all the cases. Of these patients, 90.3% (525/581) were stone-free after a single access, with a total stone-free rate of 94.6% (550/581). Thirty-five patients needed two accesses, 10 needed 3 accesses, 2 required 4 accesses, and 1 patients had 5 accesses. The operative time ranged from 30 to 150 min (mean 45 min). The successful rate of puncture was 100% without occurrence of severe injury of the pleura, intestine, peritoneum or other adjacent organs.


CONCLUSIONS
Percutaneous nephrolithotomy through the upper pole calix access allows greater stone clearance rate due to its easy access into the intrarenal collecting system and can be an ideal approach for PCNL for complicated renal calculi.
Department of Urology, Southern Medical University, Guangzhou, China. lhl.158@163.com
Hu-lin
HL
Li
Chun-xiao
CX
Liu
A-bai
AB
Xu
Kai
K
Xu
Bin-shen
BS
Chen
Kai
K
Guo
Yang-yan
YY
Lin
Rui-long
RL
Zhu
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000601:surgery*; D007670:Kidney Calices; D008096:Lithotripsy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation / Q000379:methods; D009403:Nephrostomy, Percutaneous / Q000379:methods*; D055815:Young Adult