COMPARATIVE EVALUATION OF SUPRACOSTAL AND INFRACOSTAL APPROACHES: UPPER POLE ASSESS FOR PCNL

Muhammad Faruk Hossain Sheikh*, Mohammad Manirul Islam, Mominul Haider, B. M. Saiduzzaman, Md. Obaidur Rahman and Mohammad Shafikul Islam

ABSTRACT

Introduction: Renal stone disease is a challenging problem in urological practice because of large stone burden and recurrence. The goal of stone treatment is to use a less morbid, minimally invasive and effective modality There are a lot of uncertainty with renal stone management, many factors impact on management course, stone up to 10 mm can be pass on their own, roughly, the chance of a stone passing spontaneously is inversely to the size in millimeters. Objectives: The aim of this study was to compare the safety and efficacy between suprscostal and infracostal upper pole approaches for PCNL. Methods: This Quasi experimental study was carried out in the Department of Urology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh Medical College Hospital, Popular Medical College and Hospital; and Barakah Kidney Hospital & Research Institute, Dhaka, during the period of February 2011 to January 2013, to compare the safety and efficacy between supracostal and infracostal upper pole approaches for PCNL. Results: The mean duration of operation time was found 80.9±31.7 minutes in group I and 76.5±29.2 minutes in group II. The mean length of hospital stay was 3.98±0.70 days and 4.12±0.65 days in group I and group II respectively. The mean duration of operation were higher in group I but not statistically significant (p>0.05). Conclusion: With the development of instruments and increased experience, judiciously made supracostal tracts in a single session percutaneous nephrolighotomy for treating complex stones in selected cases is safe, feasible and effective within acceptable morbidity in achieving a greater stone clearance.

Keywords: Nephrolithotomy, supracostal, infracostal, upper pole.