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Safety and efficacy of a single middle calyx access (MCA) in mini-PCNL

Urolithiasis volume 48, pages 541–546 (2020)Cite this article

Abstract

To compare outcomes of a single middle calyx access (MCA) with a single upper or lower calyceal access in mini-PCNL. From May 2015 through August 2018, patients’ files who underwent a single renal access mini-PCNL were retrospectively reviewed. All patients underwent fluoroscopic-guided access (16–20 F) in the prone position. They were categorized into group 1 (MCA) and group 2 (either upper or lower calyceal access). Compared preoperative items included stone location, size, number and complexity (according to Guy’s score). The compared outcome parameters were complication and stone-free rates. The study comprised 512 consecutive patients, 374 patients in group 1 and 138 in group 2. A single MCA was utilized to access 95% of proximal ureteral calculi, 89% for ureteropelvic junction stones, and 84% for stones present in the pelvicalyceal system and ureter. MCA was used in 89% of complete staghorn stones and 73% of multiple stones. the Stone-free rates (93% vs 90.6%, P = 0.350) and the complications rates (8% vs 7.2%, P = 0.772) were comparable between group 1 and 2 despite that MCA was used for most cases with complex stones. Complications severity were also comparable (P = 0.579). Mini-PCNL performed through a single MCA is effective and safe. This access can be used for the treatment of renal and upper ureteral calculi of different complexities and locations.

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Authors and Affiliations

  1. Department of Urology, Vayodha Hospital, Kathmandu, Nepal

    Sanjay Khadgi

  2. Urology Unit, AL-Amiri Hospital, Gulf road, Sharq, Kuwait, Kuwait

    Ahmed R. EL-Nahas & Abdullatif AL-Terki

  3. Department of Urology, University Hospital Birmingham NHS Foundation, Birmingham, UK

    Maitrey Darrad

Authors
  1. Sanjay Khadgi
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  2. Ahmed R. EL-Nahas
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  3. Maitrey Darrad
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  4. Abdullatif AL-Terki
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Correspondence to Ahmed R. EL-Nahas.

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Khadgi, S., EL-Nahas, A.R., Darrad, M. et al. Safety and efficacy of a single middle calyx access (MCA) in mini-PCNL. Urolithiasis 48, 541–546 (2020). https://doi.org/10.1007/s00240-019-01176-4

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  • DOI: https://doi.org/10.1007/s00240-019-01176-4

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