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Original Research

Comparison of success and complication rates of intercostal and subcostal approach in percutaneous nephrolithotomy


1 Ankara Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi, Ankara

2 Gazi Üniversitesi Tıp Fakültesi Hastanesi, Üroloji Anabilim Dalı, Ankara


DOI :
New J Urol. 2013; 8 (2): 40-44

Abstract

Objective: In this study, we aimed to com-pare the success and complication rates of in-tercostal and subcostal aproach in percutaneo-us nephrolithotomy.

Material and Methods: We evaluated the data of 165 patients operated at Diskapi Yil-dirim Beyazit Training and Research Hospital Department of Urology Clinic between April 2006-January 2009 for isolated upper-mid pole caliceal group stones, staghorn kidney stones and complex lower calicial stones with subcos-tal triangulation or intercostally. Subcostal tri-angulation patients were grouped as 1 (n:118) and intercostal cases were group 2 (n: 47).

Results: Mean ages of group 1 and group 2 were 44±16,3 and 44,1±13,3 respectively. Mean duration of operation time was 118,9±46,8 min and 122,1±49,5 min (p=0,32). Scopy times were 15,10±3,25 min and 6,56±5,06 min (p=0,18). The post op 6 hours heamothocrit loss was 6,46±3,94mg/dl and 5,86±4,4mg/dl (p=0,12) for group 1 and 2 respectively. Reentry ma-lecott removal time was, 3,03±2,41 days and 3,39±2,6 days (p=0,10). Residual stone sizes were 102.73±26,4 mm2 and 118±34,6 mm2 for both groups respectively (p=0,11). Duration of hospitalization was 4,53±3,8 days and 5,08±3,1 days (p=0,05) respectively. Pneumothorax and heamothorax complications were not present in either groups.

Conclusions: Intercostal access is as safe as the subcostal access when the access is per-formed between 11 and 12th intercostal spaces according to lung complications. In this way, we determined that stone-free rate, blood loss, operation, hospitalization and scopy du-rations were similar in both groups.

Key Words: Kidney stones, percutaneous nephrolithotomy


Abstract

Objective: In this study, we aimed to com-pare the success and complication rates of in-tercostal and subcostal aproach in percutaneo-us nephrolithotomy.

Material and Methods: We evaluated the data of 165 patients operated at Diskapi Yil-dirim Beyazit Training and Research Hospital Department of Urology Clinic between April 2006-January 2009 for isolated upper-mid pole caliceal group stones, staghorn kidney stones and complex lower calicial stones with subcos-tal triangulation or intercostally. Subcostal tri-angulation patients were grouped as 1 (n:118) and intercostal cases were group 2 (n: 47).

Results: Mean ages of group 1 and group 2 were 44±16,3 and 44,1±13,3 respectively. Mean duration of operation time was 118,9±46,8 min and 122,1±49,5 min (p=0,32). Scopy times were 15,10±3,25 min and 6,56±5,06 min (p=0,18). The post op 6 hours heamothocrit loss was 6,46±3,94mg/dl and 5,86±4,4mg/dl (p=0,12) for group 1 and 2 respectively. Reentry ma-lecott removal time was, 3,03±2,41 days and 3,39±2,6 days (p=0,10). Residual stone sizes were 102.73±26,4 mm2 and 118±34,6 mm2 for both groups respectively (p=0,11). Duration of hospitalization was 4,53±3,8 days and 5,08±3,1 days (p=0,05) respectively. Pneumothorax and heamothorax complications were not present in either groups.

Conclusions: Intercostal access is as safe as the subcostal access when the access is per-formed between 11 and 12th intercostal spaces according to lung complications. In this way, we determined that stone-free rate, blood loss, operation, hospitalization and scopy du-rations were similar in both groups.

Key Words: Kidney stones, percutaneous nephrolithotomy