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Safety and efficacy of superior calyceal access versus inferior calyceal access for pelvic and/or lower calyceal renal calculi- a prospective observational comparative study
Objective To compare efficacy and safety between superior calyceal access and inferior calyceal access for pelvic and/or lower calyceal renal stones. Methods Consecutive patients presenting with Pelvic and/or inferior calyceal renal calculi were allocated to the superior calyceal access (group 1) or...
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| Published in: | World journal of urology 2021-06, Vol.39 (6), p.2155-2161 |
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| creator | Amaresh, M. Hegde, P. Chawla, A. de la Rosette, J. J. M. C. H. Laguna, M. P. Kriplani, A. |
| description | Objective
To compare efficacy and safety between superior calyceal access and inferior calyceal access for pelvic and/or lower calyceal renal stones.
Methods
Consecutive patients presenting with Pelvic and/or inferior calyceal renal calculi were allocated to the superior calyceal access (group 1) or inferior calyceal access (group 2) treatment arm. Allocation of treatment access was based on the surgeon’s preference. Variables studied included stone free rate, operating time, intraoperative and postoperative complications. Statistical analysis was executed using SPSS, Version 16.0. The statistical significance was evaluated at 5% level of significance (
p
value |
| doi_str_mv | 10.1007/s00345-020-03409-3 |
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| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8216999</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2438993741</sourcerecordid><originalsourceid>FETCH-LOGICAL-c517t-25aa76425c0eaeb94393c908f6abcaba7d1d37730e21cb69082a6c5f155854c93</originalsourceid><addsrcrecordid>eNp9ks1u1TAQhS0EopfCC7CyxIZNWv_GyQYJVUCRKrEA1tbEGRdXuXGwk6A8FO-I770Vf0JsbI_nO0f26BDynLMLzpi5zIxJpSsmWFUOrK3kA7LjSsqqMaJ-SHbMCFWptpFn5EnOd4xxUzP9mJxJ0dS6btmOfP8IHueNwthT9D44cBuNnuZlwhRiog6GzSEMFJzDnOmKKS-ZhtH_u-_L3YTDGtzB87JUQ_yGv3EJx7KW0i1DqCjQKcU8oZvDijR2GdMKc4hHKO4nSHDs5Hnpt6fkkYch47P7_Zx8fvvm09V1dfPh3fur1zeV09zMldAAplZCO4aAXatkK13LGl9D56AD0_NeGiMZCu66ModGQO2051o3WrlWnpNXJ99p6fbYOxznBIOdUthD2myEYP_sjOGLvY2rbQSv2_Zg8PLeIMWvC-bZ7kN2OAwwYlyyFUo2BTOKF_TFX-hdXFL5fqG0krrhTIpCiRPlyrRyQv_zMZzZQxrsKQ22pMEe02BlEcmTKBd4vMX0y_o_qh9Vjrs2</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2543581032</pqid></control><display><type>article</type><title>Safety and efficacy of superior calyceal access versus inferior calyceal access for pelvic and/or lower calyceal renal calculi- a prospective observational comparative study</title><source>Springer Nature</source><creator>Amaresh, M. ; Hegde, P. ; Chawla, A. ; de la Rosette, J. J. M. C. H. ; Laguna, M. P. ; Kriplani, A.</creator><creatorcontrib>Amaresh, M. ; Hegde, P. ; Chawla, A. ; de la Rosette, J. J. M. C. H. ; Laguna, M. P. ; Kriplani, A.</creatorcontrib><description>Objective
To compare efficacy and safety between superior calyceal access and inferior calyceal access for pelvic and/or lower calyceal renal stones.
Methods
Consecutive patients presenting with Pelvic and/or inferior calyceal renal calculi were allocated to the superior calyceal access (group 1) or inferior calyceal access (group 2) treatment arm. Allocation of treatment access was based on the surgeon’s preference. Variables studied included stone free rate, operating time, intraoperative and postoperative complications. Statistical analysis was executed using SPSS, Version 16.0. The statistical significance was evaluated at 5% level of significance (
p
value < 0.05).
Results
Between July 2018 and February 2019, 63 patients were included in each group. The percutaneous inserted guidewire entered the ureter in 92% in group1 and 74.6% in group 2 (
p
= 0.034). Stone fragments migrated to the middle calyx in 3.2% in group1 and 9.5% in group 2 (
p
= 0.033). A second puncture was required in one patient in group 1 and in 5 patients in group 2 (
p
= 0.04). The operative duration (minutes) was 13.46 ± 1.09 in the group 1 while 16.58 ± 1.44 in the group 2 (
p
= 0.002). Thoracic complications (hydropneumothorax) occurred to 2 patients in superior calyceal access group managed with intercostal tube drainage (
p
= 0.243).Post operatively blood transfusion was required in two patients in group 2 (
p
= 0.169). Angioembolization was done in one patient among the inferior calyceal access approach (
p
= 0.683). Complete stone clearance assessed at 3 months was 96.8% in group 1 and 85.7% in group 2 (
p
= 0.046).
Conclusions
Superior calyceal access is a safe and most efficacious in terms of achieving complete stone clearance rate with reduced operative time, minimal blood loss, less need for a second puncture and auxiliary procedures at minimal complications.
Study registration
Clinical trials registry – INDIA; CTRI/2018/07/014,687.</description><identifier>ISSN: 0724-4983</identifier><identifier>EISSN: 1433-8726</identifier><identifier>DOI: 10.1007/s00345-020-03409-3</identifier><identifier>PMID: 32865690</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Blood transfusion ; Calcification (ectopic) ; Calculi ; Clinical trials ; Kidneys ; Medicine ; Medicine & Public Health ; Nephrolithiasis ; Nephrology ; Oncology ; Original ; Original Article ; Patients ; Statistical analysis ; Statistics ; Thorax ; Ureter ; Urology</subject><ispartof>World journal of urology, 2021-06, Vol.39 (6), p.2155-2161</ispartof><rights>The Author(s) 2020</rights><rights>The Author(s) 2020. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c517t-25aa76425c0eaeb94393c908f6abcaba7d1d37730e21cb69082a6c5f155854c93</citedby><cites>FETCH-LOGICAL-c517t-25aa76425c0eaeb94393c908f6abcaba7d1d37730e21cb69082a6c5f155854c93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids></links><search><creatorcontrib>Amaresh, M.</creatorcontrib><creatorcontrib>Hegde, P.</creatorcontrib><creatorcontrib>Chawla, A.</creatorcontrib><creatorcontrib>de la Rosette, J. J. M. C. H.</creatorcontrib><creatorcontrib>Laguna, M. P.</creatorcontrib><creatorcontrib>Kriplani, A.</creatorcontrib><title>Safety and efficacy of superior calyceal access versus inferior calyceal access for pelvic and/or lower calyceal renal calculi- a prospective observational comparative study</title><title>World journal of urology</title><addtitle>World J Urol</addtitle><description>Objective
To compare efficacy and safety between superior calyceal access and inferior calyceal access for pelvic and/or lower calyceal renal stones.
Methods
Consecutive patients presenting with Pelvic and/or inferior calyceal renal calculi were allocated to the superior calyceal access (group 1) or inferior calyceal access (group 2) treatment arm. Allocation of treatment access was based on the surgeon’s preference. Variables studied included stone free rate, operating time, intraoperative and postoperative complications. Statistical analysis was executed using SPSS, Version 16.0. The statistical significance was evaluated at 5% level of significance (
p
value < 0.05).
Results
Between July 2018 and February 2019, 63 patients were included in each group. The percutaneous inserted guidewire entered the ureter in 92% in group1 and 74.6% in group 2 (
p
= 0.034). Stone fragments migrated to the middle calyx in 3.2% in group1 and 9.5% in group 2 (
p
= 0.033). A second puncture was required in one patient in group 1 and in 5 patients in group 2 (
p
= 0.04). The operative duration (minutes) was 13.46 ± 1.09 in the group 1 while 16.58 ± 1.44 in the group 2 (
p
= 0.002). Thoracic complications (hydropneumothorax) occurred to 2 patients in superior calyceal access group managed with intercostal tube drainage (
p
= 0.243).Post operatively blood transfusion was required in two patients in group 2 (
p
= 0.169). Angioembolization was done in one patient among the inferior calyceal access approach (
p
= 0.683). Complete stone clearance assessed at 3 months was 96.8% in group 1 and 85.7% in group 2 (
p
= 0.046).
Conclusions
Superior calyceal access is a safe and most efficacious in terms of achieving complete stone clearance rate with reduced operative time, minimal blood loss, less need for a second puncture and auxiliary procedures at minimal complications.
Study registration
Clinical trials registry – INDIA; CTRI/2018/07/014,687.</description><subject>Blood transfusion</subject><subject>Calcification (ectopic)</subject><subject>Calculi</subject><subject>Clinical trials</subject><subject>Kidneys</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Nephrolithiasis</subject><subject>Nephrology</subject><subject>Oncology</subject><subject>Original</subject><subject>Original Article</subject><subject>Patients</subject><subject>Statistical analysis</subject><subject>Statistics</subject><subject>Thorax</subject><subject>Ureter</subject><subject>Urology</subject><issn>0724-4983</issn><issn>1433-8726</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9ks1u1TAQhS0EopfCC7CyxIZNWv_GyQYJVUCRKrEA1tbEGRdXuXGwk6A8FO-I770Vf0JsbI_nO0f26BDynLMLzpi5zIxJpSsmWFUOrK3kA7LjSsqqMaJ-SHbMCFWptpFn5EnOd4xxUzP9mJxJ0dS6btmOfP8IHueNwthT9D44cBuNnuZlwhRiog6GzSEMFJzDnOmKKS-ZhtH_u-_L3YTDGtzB87JUQ_yGv3EJx7KW0i1DqCjQKcU8oZvDijR2GdMKc4hHKO4nSHDs5Hnpt6fkkYch47P7_Zx8fvvm09V1dfPh3fur1zeV09zMldAAplZCO4aAXatkK13LGl9D56AD0_NeGiMZCu66ModGQO2051o3WrlWnpNXJ99p6fbYOxznBIOdUthD2myEYP_sjOGLvY2rbQSv2_Zg8PLeIMWvC-bZ7kN2OAwwYlyyFUo2BTOKF_TFX-hdXFL5fqG0krrhTIpCiRPlyrRyQv_zMZzZQxrsKQ22pMEe02BlEcmTKBd4vMX0y_o_qh9Vjrs2</recordid><startdate>20210601</startdate><enddate>20210601</enddate><creator>Amaresh, M.</creator><creator>Hegde, P.</creator><creator>Chawla, A.</creator><creator>de la Rosette, J. J. M. C. H.</creator><creator>Laguna, M. P.</creator><creator>Kriplani, A.</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20210601</creationdate><title>Safety and efficacy of superior calyceal access versus inferior calyceal access for pelvic and/or lower calyceal renal calculi- a prospective observational comparative study</title><author>Amaresh, M. ; Hegde, P. ; Chawla, A. ; de la Rosette, J. J. M. C. H. ; Laguna, M. P. ; Kriplani, A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c517t-25aa76425c0eaeb94393c908f6abcaba7d1d37730e21cb69082a6c5f155854c93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Blood transfusion</topic><topic>Calcification (ectopic)</topic><topic>Calculi</topic><topic>Clinical trials</topic><topic>Kidneys</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Nephrolithiasis</topic><topic>Nephrology</topic><topic>Oncology</topic><topic>Original</topic><topic>Original Article</topic><topic>Patients</topic><topic>Statistical analysis</topic><topic>Statistics</topic><topic>Thorax</topic><topic>Ureter</topic><topic>Urology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Amaresh, M.</creatorcontrib><creatorcontrib>Hegde, P.</creatorcontrib><creatorcontrib>Chawla, A.</creatorcontrib><creatorcontrib>de la Rosette, J. J. M. C. H.</creatorcontrib><creatorcontrib>Laguna, M. P.</creatorcontrib><creatorcontrib>Kriplani, A.</creatorcontrib><collection>SpringerOpen</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>ProQuest Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>World journal of urology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Amaresh, M.</au><au>Hegde, P.</au><au>Chawla, A.</au><au>de la Rosette, J. J. M. C. H.</au><au>Laguna, M. P.</au><au>Kriplani, A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Safety and efficacy of superior calyceal access versus inferior calyceal access for pelvic and/or lower calyceal renal calculi- a prospective observational comparative study</atitle><jtitle>World journal of urology</jtitle><stitle>World J Urol</stitle><date>2021-06-01</date><risdate>2021</risdate><volume>39</volume><issue>6</issue><spage>2155</spage><epage>2161</epage><pages>2155-2161</pages><issn>0724-4983</issn><eissn>1433-8726</eissn><abstract>Objective
To compare efficacy and safety between superior calyceal access and inferior calyceal access for pelvic and/or lower calyceal renal stones.
Methods
Consecutive patients presenting with Pelvic and/or inferior calyceal renal calculi were allocated to the superior calyceal access (group 1) or inferior calyceal access (group 2) treatment arm. Allocation of treatment access was based on the surgeon’s preference. Variables studied included stone free rate, operating time, intraoperative and postoperative complications. Statistical analysis was executed using SPSS, Version 16.0. The statistical significance was evaluated at 5% level of significance (
p
value < 0.05).
Results
Between July 2018 and February 2019, 63 patients were included in each group. The percutaneous inserted guidewire entered the ureter in 92% in group1 and 74.6% in group 2 (
p
= 0.034). Stone fragments migrated to the middle calyx in 3.2% in group1 and 9.5% in group 2 (
p
= 0.033). A second puncture was required in one patient in group 1 and in 5 patients in group 2 (
p
= 0.04). The operative duration (minutes) was 13.46 ± 1.09 in the group 1 while 16.58 ± 1.44 in the group 2 (
p
= 0.002). Thoracic complications (hydropneumothorax) occurred to 2 patients in superior calyceal access group managed with intercostal tube drainage (
p
= 0.243).Post operatively blood transfusion was required in two patients in group 2 (
p
= 0.169). Angioembolization was done in one patient among the inferior calyceal access approach (
p
= 0.683). Complete stone clearance assessed at 3 months was 96.8% in group 1 and 85.7% in group 2 (
p
= 0.046).
Conclusions
Superior calyceal access is a safe and most efficacious in terms of achieving complete stone clearance rate with reduced operative time, minimal blood loss, less need for a second puncture and auxiliary procedures at minimal complications.
Study registration
Clinical trials registry – INDIA; CTRI/2018/07/014,687.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>32865690</pmid><doi>10.1007/s00345-020-03409-3</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| issn | 0724-4983 1433-8726 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8216999 |
| source | Springer Nature |
| subjects | Blood transfusion Calcification (ectopic) Calculi Clinical trials Kidneys Medicine Medicine & Public Health Nephrolithiasis Nephrology Oncology Original Original Article Patients Statistical analysis Statistics Thorax Ureter Urology |
| title | Safety and efficacy of superior calyceal access versus inferior calyceal access for pelvic and/or lower calyceal renal calculi- a prospective observational comparative study |
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