In this study, we aimed to present the results of subcostal percutaneous nephrolitotomy operation in patients with upper calyces stone. The operation records of 44 patients who had undergone subcostal percutaneous nephrolitotomy for upper calyces stone were retrospectively evaluated. The situations of stone-free and clinically insignificant residual fragments (<4 mm and not causing obstruction) were accepted as success. The mean age of the patients was 44 (7–71) years, and the mean stone load was 805 (120–2240) mm². Of the 44 patients, 18 (42.3%) had isolated upper calyces stone and 26 (59.09%) had complex renal pelvis stones including upper and lower calyceal systems. Single and double accesses were performed in 38 (86.3%) and 6 (13.6%) of the patients, respectively. Of a total of 50 renal accesses, 18 (36%) were performed to middle and upper pole with a subcostal-triangulation technique and 32 (64%) were performed to lower and/or middle pole with a subcostal-direct technique. The situations of stone-free and clinically insignificant residual fragments were detected in 27 (61.3%) and 8 (18.1%) of the patients, respectively. Regarding complications, blood transfusion was required in 11 (25%) patients and hydropneumothorax developed in one (2.2%) patient. We conclude that a success rate of about 80% may be achieved with subcostal approach in selected patients with upper calyces stones especially by urologists who have little experience of percutaneous surgery.
Keywords: Renal stone, percutaneous nephrolitotomy, subcostal approach
