title: A comparison of supracostal and infracostal access approaches in treating renal and upper ureteral stones using MPCNL with the aid of a patented system.
abstract: BACKGROUND
  There are still disagreements on which is a better approach to choose to establish percutaneous tract for percutaneous nephrolitotomy (PCNL), between supracostal and infracostal approaches. The aim of this study is to investigate the safety, efficacy and practicability of minimally invasive PCNL (MPCNL) with the aid of a patented system either through supracostal or through infracostal access.
  
  
  METHODS
  A retrospective study was carried out for 83 patients with renal or upper ureteral stones. Under the guidance of B ultrasound or C-arm, these patients were treated by MPCNL through either 12th rib infracostal (Group 1, 43 cases) or supracostal (Group 2, 40 cases) access approach. These 2 groups were compared for total number of percutaneous tracts, average time in establishing a given percutaneous tract, the number of percutaneous tract used for each case, the average stone clearance time, the clearance rate of all stones by one surgery, and the amount of bleeding using a single percutaneous tract.
  
  
  RESULTS
  There was a significantly smaller total number of percutaneous tracts needed, a smaller number of cases that needed two percutaneous tracts to clear stones completely, a shorter average time in establishing a percutaneous tract, and a smaller average amount of bleeding in infracostal access group. At the same time, there were a significantly larger number of cases in which stones were cleared completely using a single percutaneous tract and a higher renal stone clearance rate by one surgery.
  
  
  CONCLUSIONS
  There were several advantages of infracostal access. These included accuracy in establishing a percutaneous tract, safety, quickness, convenience and flexibility in moving the patented sheath, and higher renal and upper ureteral stone clearance rate by one surgery.
authors.affiliation: Department of Urology, The Affiliated Ganzhou City People's Hospital of Nanchang University, Ganzhou, Jiangxi, 341000, China. fandifu@126.com.
authors.forename: Difu
authors.initials: D
authors.lastname: Fan
authors.affiliation: Department of Urology, The Affiliated Ganzhou City People's Hospital of Nanchang University, Ganzhou, Jiangxi, 341000, China. xdh888@yahoo.com.
authors.forename: Leming
authors.initials: L
authors.lastname: Song
authors.affiliation: Department of Urology, The Affiliated Ganzhou City People's Hospital of Nanchang University, Ganzhou, Jiangxi, 341000, China. xiedh07@gmail.com.
authors.forename: Donghua
authors.initials: D
authors.lastname: Xie
authors.affiliation: Department of Urology, The Affiliated Ganzhou City People's Hospital of Nanchang University, Ganzhou, Jiangxi, 341000, China. gzshm2005@126.com.
authors.forename: Min
authors.initials: M
authors.lastname: Hu
authors.affiliation: Department of Urology, The Affiliated Ganzhou City People's Hospital of Nanchang University, Ganzhou, Jiangxi, 341000, China. pzf5201@163.com.
authors.forename: Zuofeng
authors.initials: Z
authors.lastname: Peng
authors.affiliation: Dermatology Institute of Gan County, Jiangxi, 341100, China. ddh418@gmail.com.
authors.forename: Xiaohui
authors.initials: X
authors.lastname: Liao
authors.affiliation: Department of Urology, The Affiliated Ganzhou City People's Hospital of Nanchang University, Ganzhou, Jiangxi, 341000, China. tttrong@126.com.
authors.forename: Tairong
authors.initials: T
authors.lastname: Liu
authors.affiliation: Department of Urology, The Affiliated Ganzhou City People's Hospital of Nanchang University, Ganzhou, Jiangxi, 341000, China. duchuance@126.com.
authors.forename: Chuance
authors.initials: C
authors.lastname: Du
authors.affiliation: Department of Urology, The Affiliated Ganzhou City People's Hospital of Nanchang University, Ganzhou, Jiangxi, 341000, China. doctorzlf@sohu.com.
authors.forename: Lunfeng
authors.initials: L
authors.lastname: Zhu
authors.affiliation: Department of Urology, The Affiliated Ganzhou City People's Hospital of Nanchang University, Ganzhou, Jiangxi, 341000, China. yaoshisan4@163.com.
authors.forename: Lei
authors.initials: L
authors.lastname: Yao
authors.affiliation: Department of Urology, The Affiliated Ganzhou City People's Hospital of Nanchang University, Ganzhou, Jiangxi, 341000, China. 119220468@qq.com.
authors.forename: Jianrong
authors.initials: J
authors.lastname: Huang
authors.affiliation: Department of Urology, The Affiliated Ganzhou City People's Hospital of Nanchang University, Ganzhou, Jiangxi, 341000, China. zhongshengyang@126.com.
authors.forename: Zhongsheng
authors.initials: Z
authors.lastname: Yang
authors.affiliation: Department of Urology, The Affiliated Ganzhou City People's Hospital of Nanchang University, Ganzhou, Jiangxi, 341000, China. gshul2007@163.com.
authors.forename: Shulin
authors.initials: S
authors.lastname: Guo
authors.affiliation: Department of Urology, The Affiliated Ganzhou City People's Hospital of Nanchang University, Ganzhou, Jiangxi, 341000, China. qinwen1964@126.com.
authors.forename: Wen
authors.initials: W
authors.lastname: Qin
authors.affiliation: Department of Urology, The Affiliated Ganzhou City People's Hospital of Nanchang University, Ganzhou, Jiangxi, 341000, China. ddh418@gmail.com.
authors.forename: Jiuqing
authors.initials: J
authors.lastname: Zhong
authors.affiliation: Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China. zhangqun_ye@yahoo.com.cn.
authors.forename: Zhangqun
authors.initials: Z
authors.lastname: Ye
mesh_terms: D000328:Adult; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation* / Q000379:methods; D009403:Nephrostomy, Percutaneous / Q000295:instrumentation* / Q000379:methods; D010330:Patents as Topic; D012272:Ribs / Q000601:surgery; D013396:Suction / Q000295:instrumentation / Q000379:methods; D025321:Surgery, Computer-Assisted / Q000295:instrumentation; D018511:Systems Integration; D007507:Therapeutic Irrigation / Q000295:instrumentation* / Q000379:methods; D016896:Treatment Outcome; D014514:Ureteral Calculi / Q000175:diagnosis / Q000601:surgery*