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Minerva Urologica e Nefrologica 2020 Nov 17

DOI: 10.23736/S0393-2249.20.04002-3


language: English

The impact of anterior calyceal stones on the outcomes of percutaneous nephrolithotomy for complex kidney stones: a comparative study

Ahmet SAHAN 1 , Erdinc DINCER 1, Orkunt ÖZKAPTAN 1, Alkan CUBUK 1, Kasim ERTAS 2, Bilal ERYILDIRIM 1, Oktay AKCA 1

1 Department of Urology, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey; 2 Department of Urology, Yuzuncu Yil University, School of Medicine, Van, Turkey


BACKGROUND: This study aimed to evaluate the possible effect of anterior calyceal stones on the surgical outcomes of percutaneous nephrolithotomy.
METHODS: Consecutive patients with complex kidney stones from 2012 to 2020 were evaluated retrospectively. In total, 219 patients were divided into 2 groups based on the presence of anterior calyceal stones (group 1; n=89) or not (group 2; n=130). The groups were compared in terms of surgical outcomes (i.e., stonefree rate [SFR], operation time, and hemoglobin drop) and complications.
RESULTS: The patient demographics and stone characteristics were similar between the groups. Multiple access was more frequently done in group 1 than it was in group 2 (47.2% vs. 30.8%; p = 0.014), and the SFR was lower in group 1 (51.7%) than it was in group 2 (67.7%; p = 0.017). Of the anterior calyceal stones in group 1, 42.6% could not be cleaned. However, when excluding patients who have only anterior residual stones from the statistical analysis, the groups had similar SFRs (68.5% vs. 67.7% for group 1 and group 2, respectively).
CONCLUSIONS: The presence of complex kidney stones with anterior calyceal extension are associated with higher residual stones rates in the anterior calyx. Also, it increases multiple access, the operation time, and level of hemoglobin drop.

KEY WORDS: Anterior calyceal stone; Stone free rate; Complex kidney stones; Operation time; Multiple access

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