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BMC Urology
Published in: BMC Urology 1/2015

Open Access 01-12-2015 | Technical advance

A comparison of supracostal and infracostal access approaches in treating renal and upper ureteral stones using MPCNL with the aid of a patented system

Authors: Difu Fan, Leming Song, Donghua Xie, Min Hu, Zuofeng Peng, Xiaohui Liao, Tairong Liu, Chuance Du, Lunfeng Zhu, Lei Yao, Jianrong Huang, Zhongsheng Yang, Shulin Guo, Wen Qin, Jiuqing Zhong, Zhangqun Ye

Published in: BMC Urology | Issue 1/2015

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Abstract

Background

There are still disagreements on which is a better approach to choose to establish percutaneous tract for percutaneous nephrolitotomy (PCNL), between supracostal and infracostal approaches. The aim of this study is to investigate the safety, efficacy and practicability of minimally invasive PCNL (MPCNL) with the aid of a patented system either through supracostal or through infracostal access.

Methods

A retrospective study was carried out for 83 patients with renal or upper ureteral stones. Under the guidance of B ultrasound or C-arm, these patients were treated by MPCNL through either 12th rib infracostal (Group 1, 43 cases) or supracostal (Group 2, 40 cases) access approach. These 2 groups were compared for total number of percutaneous tracts, average time in establishing a given percutaneous tract, the number of percutaneous tract used for each case, the average stone clearance time, the clearance rate of all stones by one surgery, and the amount of bleeding using a single percutaneous tract.

Results

There was a significantly smaller total number of percutaneous tracts needed, a smaller number of cases that needed two percutaneous tracts to clear stones completely, a shorter average time in establishing a percutaneous tract, and a smaller average amount of bleeding in infracostal access group. At the same time, there were a significantly larger number of cases in which stones were cleared completely using a single percutaneous tract and a higher renal stone clearance rate by one surgery.

Conclusion

There were several advantages of infracostal access. These included accuracy in establishing a percutaneous tract, safety, quickness, convenience and flexibility in moving the patented sheath, and higher renal and upper ureteral stone clearance rate by one surgery.
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Metadata
Title
A comparison of supracostal and infracostal access approaches in treating renal and upper ureteral stones using MPCNL with the aid of a patented system
Authors
Difu Fan
Leming Song
Donghua Xie
Min Hu
Zuofeng Peng
Xiaohui Liao
Tairong Liu
Chuance Du
Lunfeng Zhu
Lei Yao
Jianrong Huang
Zhongsheng Yang
Shulin Guo
Wen Qin
Jiuqing Zhong
Zhangqun Ye
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Urology / Issue 1/2015
Electronic ISSN: 1471-2490
DOI
https://doi.org/10.1186/s12894-015-0097-3

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