CU 27. Safety and efficacy of percutaneous nephrolithotomy with supracostal approach in the treatment of renal stones

Objective: To evaluate the safety and efficacy of percutaneous nephrolithotomy (PCNL) with supracostal approach in the treatment of renal stones.

Methods: A retrospective chart review was performed of 485 renal calculi patients who underwent ultrasound-guided PCNL in our hospital from March 2004 to May 2011. Among them, 88 cases were under supracostal approach and 397 cases under infracostal approach. The indications of supracostal approach included staghorn stones, complex inferior calyceal stones, and stones in the upper calyx or the upper ureter. All punctures were made by the urologist under ultrasound-guided in the prone position. All supracostal choices were between 11th and 12th rib. The operation duration, success rate, puncture attempts, hospital stay, and complications were evaluated.

Results: No differences were found in terms of operation duration, puncture attempts, and hospital stay between these two groups. The success rate in the supracostal group (90.2%) and in the infracostal group (93.9%) was also not significantly different (P>0.05). The overall complication rates across groups were low (11.6%).

Conclusions: The supracostal approach is safe and effective in treating renal stones.