Details

Autor(en) / Beteiligte

• Binbay, Murat
• Akman, Tolga
• Ozgor, Faruk
• Yazici, Ozgur
• Sari, Erhan
• Erbin, Akif
• Kezer, Cem
• Sarilar, Omer
• Berberoglu, Yalcın
• Muslumanoglu, Ahmet Yaser

Titel

Does Pelvicaliceal System Anatomy Affect Success of Percutaneous Nephrolithotomy?

Ist Teil von

• Urology (Ridgewood, N.J.), 2011-10, Vol.78 (4), p.733-737

Ort / Verlag

New York, NY: Elsevier Inc

Erscheinungsjahr

2011

Quelle

MEDLINE

Beschreibungen/Notizen

• Objective To investigate the effect of the pelvicaliceal system (PCS) anatomy on the percutaneous nephrolithotomy (PCNL) success rate. Although the caliceal anatomy is effective for stone clearance after shock wave lithotripsy and retrograde intrarenal lithotripsy, the effect of the caliceal anatomy after PCNL has not been evaluated to date. Methods A total of 498 patients who had undergone PCNL and preoperative intravenous urography were enrolled in our study. Kidney-related anatomic factors, such as the PCS surface area and type, degree of hydronephrosis, infundibulopelvic angle, upper-lower calix angle, infundibular length, and infundibular width were calculated using intravenous urography. The association between the PCNL success rate and kidney-related anatomic factors was retrospectively analyzed using chi-square tests, Fisher's exact test, Mann-Whitney U test, and forward stepwise regression analysis. Results A success rate of 78.1% was achieved. No difference was seen the success rates among the PCS types. The mean PCS surface area was 20.1 ± 9.7 cm2 in patients with successful outcomes and 24.5 ± 10.2 cm2 in patients with remaining stones ( P = .001). The mean infundibulopelvic angle, upper-lower calix angle, infundibular length, and infundibular width were similar in both groups. Multivariate binary logistic regression analysis showed that stone configuration and PCS surface area were independent factors affecting the PCNL success rates. Conclusion The results of our study have shown that the PCS surface area is the only anatomic factor that affects the PCNL success rate and patients with a PCS surface area <20.5 cm2 have greater PCNL success.