Comparison of stone clearance rate based on upper, middle, or lower calyx puncture in Mini Percutaneous Nephrolithotomy (mPCNL)

  • Kushal Karki
  • Narayan Bhusal


1. Trinchieri A. Epidemiology of urolithiasis: an update. Clin Cases Miner Bone Metab. 2008;5(2):101-6.
2. Sabler IM, Katafigiotis I, Gofrit ON, Duvdevani M. Present indications and techniques of percutaneous nephrolithotomy: What the future holds? Asian J Urol. 2018 Oct 1;5(4):287–94.
3. Gadzhiev NK, Obidnyak VM, Gorelov DS, Malkhasyan VA, Akopyan GN, Mazurenko DA, et al. Complications after PCNL: diagnosis and management. Urologiia. 2020 Nov:(5):139–48.
4. Soares RMO, Zhu A, Talati VM, Nadler RB. Upper Pole Access for Prone Percutaneous Nephrolithotomy: Advantage or Risk? Urology. 2019 Dec 1;134:66–71.
5. Aron M, Goel R, Kesarwani PK, Seth A, Gupta NP. Upper pole access for complex lower pole renal calculi. BJU Int. 2004 Oct;94(6):849–52.
6. Khadgi S, EL-Nahas AR, Darrad M, AL-Terki A. Safety and efficacy of a single middle calyx access (MCA) in mini-PCNL. Urolithiasis. 2019 Dec 10;48(6):541–6.
7. Rai A, Kozel Z, Hsieh A, Aro T, Smith A, Hoenig D, et al. Management of Colon Perforation During Percutaneous Nephrolithotomy in Patients with Complex Anatomy: A Case Series. J Endourol Case Reports. 2020;6(4):416.
8. Ermis O, Somani B, Reeves T, Guven S, Pes PL, Chawla A, et al. Definition, treatment and outcome of residual fragments in staghorn stones. Asian J Urol. 2020 Apr 1;7(2):116–21.
9. Lahme S. Miniaturisation of PCNL. Urolithiasis 2017;46(1):99–106.
10. Binbay M, Akman T, Ozgor F, Yazici O, Sari E, Erbin A, et al. Does Pelvicaliceal System Anatomy Affect Success of Percutaneous Nephrolithotomy? Urology. 2011 Oct 1;78(4):733–7.
11. Aron M, Yadav R, Goel R, Kolla SB, Gautam G, Hemal AK et al. Multi-Tract Percutaneous Nephrolithotomy for Large Complete Staghorn Calculi. Urol Int. 2005;75(4):327-32.
12. Turney BW. A New Model with an Anatomically Accurate Human Renal Collecting System for Training in Fluoroscopy-Guided Percutaneous Nephrolithotomy Access. J Endourol. 2014 Mar;28(3):360-3.
13. Singh V, Garg Y, Sharma K, Sinha RJ, Gupta S. Prospective randomized comparison between superior calyceal access versus inferior calyceal access in PCNL for inferior calyceal stones with or without pelvic stones. Urolithiasis. 2015;44(2):161–5.
14. Netto NR, Ikonomidis J, Ikari O, Claro JA. Comparative study of percutaneous access for staghorn calculi. Urology. 2005;65(4):659–62.
15. Verma A, Tomar V, Yadav S. Complex multiple renal calculi: stone distribution, pelvicalyceal anatomy and site of puncture as predictors of PCNL outcome. Springerplus. 2016 Dec 1;5(1):1–6.
16. Singh R, Kankalia SP, Sabale V, Satav V, Mane D, Mulay A, et al. Comparative evaluation of upper versus lower calyceal approach in percutaneous nephrolithotomy for managing complex renal calculi. Urol Ann. 2015 Jan 1;7(1):31-5.
17. Gunawan S, Birowo P, Rasyid N, Atmoko W, Zeng G. Outcome and safety of upper pole versus non-upper pole single puncture PCNL for staghorn stones: a systematic review and meta-analysis [version 1; peer review: 2 approved with reservations]. F1000Research.2019;8:537.
18. El-Nahas AR, Shokeir AA, El-Assmy AM, Mohsen T, Shoma AM, Eraky I, et al. Post-Percutaneous Nephrolithotomy Extensive Hemorrhage: A Study of Risk Factors. J Urol. 2007 Feb;177(2):576–9.
19. Munver R, Delvecchio FC, Newman GE, Preminger GM. Critical analysis of supracostal access for percutaneous renal surgery. J Urol. 2001;166(4):1242-6.
20. Sukumar S, Nair B, Kumar PG, Sanjeevan K V, Bhat HS. Supracostal access for percutaneous nephrolithotomy: less morbid, more effective. Int Urol Nephrol. 2008 Jun;40(2):263–7.
21. Lojanapiwat B, Prasopsuk S. Upper-pole access for percutaneous nephrolithotomy: comparison of supracostal and infracostal approaches. J Endourol. 2006 Jul;20(7):491–4.
How to Cite
KARKI, Kushal; BHUSAL, Narayan. Comparison of stone clearance rate based on upper, middle, or lower calyx puncture in Mini Percutaneous Nephrolithotomy (mPCNL). J Soc Surg Nep, [S.l.], v. 26, n. 2, p. 64-69, dec. 2023. ISSN 2392-4772. Available at: <>. Date accessed: 13 june 2024.