Objectives: It was the aim of this study to evaluate and compare the outcomes of percutaneous nephrolithotomy (PNL) for the treatment of posterior and anterior caliceal stones. Patients and Methods: We performed a retrospective analysis of 86 patients with isolated caliceal stones who underwent PNL between 2011 and 2012. The patients were classified into two groups according to the localization of the stone, either in the anterior (group 1, n = 41) or posterior (group 2, n = 45) calyx, on axial plane computed tomography. Results: The mean age, male/female ratio and stone size and location were similar in both groups. Fluoroscopy, operation time and duration of hospitalization were also similar between groups. Patients in group 1 had a greater postoperative hemoglobin drop than patients in group 2. Blood transfusion was required for 5 patients in group 1 and for 4 patients in group 2. In addition, open conversion was required for 2 patients in group 1 during the early postoperative period because of extensive bleeding. Hemodynamics were stabilized with angioembolization in 2 patients with prolonged hematuria in group 1. The overall success and complication rates were similar in both groups. Conclusion: Although the postoperative hemoglobin drop did not significantly differ between groups, hemorrhaging was more severe in patients with anterior caliceal stones than in those with posterior caliceal stones.

1.
Fernström I, Johansson B: Percutaneous pyelolithotomy. A new extraction technique. Scand J Urol Nephrol 1976;10:257-259.
2.
Türk C, Knoll T, Petrik A, et al: Guidelines on urolithiasis. http://www.uroweb.org/gls/pdf/Urolithiasis%202010.pdf.
3.
de la Rosette J, Assimos D, Desai M, Gutierrez J, Lingeman J, Scarpa R, Tefekli A; CROES PCNL Study Group: The Clinical Research Office of the Endourological Society Percutaneous Nephrolithotomy Global Study: indications, complications, and outcomes in 5803 patients. J Endourol 2011;25:11-17.
4.
Rassweiler JJ, Renner C, Eisenberger F: The management of complex stones. BJU Int 2000;86:919-928.
5.
Michel MS, Trojan L, Rassweiler JJ: Complications in percutaneous nephrolithotomy. Eur Urol 2007;51:899-906.
6.
Turna B, Ekren F, Nazli O, et al: Comparative results of shockwave lithotripsy for renal calculi in upper, middle, and lower calices. J Endourol 2007;21:951-956.
7.
Wang Y, Jiang F, Wang Y, et al: Post-percutaneous nephrolithotomy septic shock and severe hemorrhage: a study of risk factors. Urol Int 2012;88:307-310.
8.
Turna B, Umul M, Demiryoguran S, et al: How do increasing stone surface area and stone configuration affect overall outcome of percutaneous nephrolithotomy? J Endourol 2007;21:34-43.
9.
Binbay M, Akman T, Ozgor F, et al: Does pelvicaliceal system anatomy affect success of percutaneous nephrolithotomy? Urology 2011;78:733-737.
10.
Resorlu B, Oguz U, Resorlu EB, et al: The impact of pelvicaliceal anatomy on the success of retrograde intrarenal surgery in patients with lower pole renal stones. Urology 2012;79:61-66.
11.
Unsal A, Resorlu B, Atmaca AF, et al: Prediction of morbidity and mortality after percutaneous nephrolithotomy by using the Charlson comorbidity index. Urology 2012;79:55-60.
12.
Dindo D, Demartines N, Clavien PA: Classification of surgical complications: a new proposal with evaluation in a cohort of 6,336 patients and results of a survey. Ann Surg 2004;240:205-213.
13.
de la Rosette JJ, Opondo D, Daels FP, Giusti G, Serrano A, Kandasami SV, Wolf JS Jr, Grabe M, Gravas S, CROES PCNL Study Group: Categorisation of complications and validation of the Clavien score for percutaneous nephrolithotomy. Eur Urol 2012;62:246-255.
14.
Wolf JS Jr: Percutaneous approaches to the upper urinary tract collecting system; in Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA (eds): Campbell-Walsh Urology, ed 10. Philadelphia, Saunders Elsevier, 2012, pp 1321-1353.
15.
Sampaio FJ, Pereira-Sampaio MA, Favorito LA: The pig kidney as an endourologic model: anatomic contribution. J Endourol 1998;12:45-50.
16.
Eisner BH, Cloyd J, Stoller ML: Lower-pole fluoroscopy-guided percutaneous renal access: which calix is posterior? J Endourol 2009;23:1621-1625.
17.
Lipkin ME, Mancini JG, Zilberman DE, et al: Reduced radiation exposure with the use of an air retrograde pyelogram during fluoroscopic access for percutaneous nephrolithotomy. J Endourol 2011;25:563-567.
18.
Kukreja R, Desai M, Patel S, et al: Factors affecting blood loss during percutaneous nephrolithotomy: prospective study. J Endourol 2004;18:715-722.
19.
Turna B, Nazli O, Demiryoguran S, et al: Percutaneous nephrolithotomy: variables that influence hemorrhage. Urology 2007;69:603-607.
20.
Akman T, Binbay M, Sari E, et al: Factors affecting bleeding during percutaneous nephrolithotomy: single surgeon experience. J Endourol 2011;25:327-333.
21.
Skolarikos A, de la Rosette J: Prevention and treatment of complications following percutaneous nephrolithotomy. Curr Opin Urol 2008;18:229-234.
22.
Amer T, Ahmed K, Bultitude M, Khan S, Kumar P, De Rosa A, Khan MS, Hegarty N: Standard versus tubeless percutaneous nephrolithotomy: a systematic review. Urol Int 2012;88:373-382.
23.
Lojanapiwat B, Kitirattrakarn P: Role of preoperative and intraoperative factors in mediating infection complication following percutaneous nephrolithotomy. Urol Int 2011;86:448-452.
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