Comparison of Monoplanar and Biplanar Access Techniques for Percutaneous Nephrolithotomy.
OBJECTIVE
The aim of this study was to compare the positive aspects and complications of monoplanar and biplanar access techniques used in percutaneous nephrolithotomy (PCNL) based on the modified Clavien complication grading system.


METHODS
The data from patients who underwent PCNL using either monoplanar access (group 1) or biplanar access (group 2) techniques were analyzed retrospectively. For the biplanar technique, puncture is adjusted based on different fluoroscopic projections, including vertical and 30 degree positions. For the monoplanar technique, a C-arm fluoroscope was brought into vertical position, the collecting system was visualized with a contrast agent, and the most appropriate calix was selected to extract the targeted stone.


RESULTS
The monoplanar technique was performed for renal access in 310 patients (group 1), and the biplanar technique was used for renal access in 351 patients (group 2). There were no statistically significant differences between the two groups with regard to demographic data. The mean puncture time was significantly lower in group 1 (monoplanar) when compared with that of group 2 (biplanar, P=0.04). The overall success rates of the monoplanar and biplanar groups were 88% and 89% (including clinically insignifican residual fragments in 9% and 7%), respectively (P>0.05), and the complication rates of both groups were similar.


CONCLUSIONS
The monoplanar access technique, which is safe to use, decreases puncture time, minimizes the surgeon's direct exposure time to radiation, and has similar success rates as the biplanar access technique.
1 Department of Urology, Dicle University School of Medicine , Diyarbakir, Turkey .
Onur
O
Dede
2 Department of Urology, S.B. Onkoloji Training and Research Hospital , Ankara, Turkey .
Okan
O
Bas
1 Department of Urology, Dicle University School of Medicine , Diyarbakir, Turkey .
Ahmet Ali
AA
Sancaktutar
1 Department of Urology, Dicle University School of Medicine , Diyarbakir, Turkey .
Mansur
M
Daggulli
1 Department of Urology, Dicle University School of Medicine , Diyarbakir, Turkey .
Mazhar
M
Utangac
1 Department of Urology, Dicle University School of Medicine , Diyarbakir, Turkey .
Necmettin
N
Penbegul
1 Department of Urology, Dicle University School of Medicine , Diyarbakir, Turkey .
Namik Kemal
NK
Hatipoglu
1 Department of Urology, Dicle University School of Medicine , Diyarbakir, Turkey .
Mehmet Nuri
MN
Bodakci
1 Department of Urology, Dicle University School of Medicine , Diyarbakir, Turkey .
Yasar
Y
Bozkurt
D000328:Adult; D003287:Contrast Media; D003710:Demography; D005260:Female; D005471:Fluoroscopy / Q000379:methods; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging; D007669:Kidney Calculi / Q000000981:diagnostic imaging; D007670:Kidney Calices / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000295:instrumentation* / Q000379:methods*; D061646:Operative Time; D012189:Retrospective Studies; D016896:Treatment Outcome
D003287:Contrast Media