Fax +41 61 306 12 34 E-Mail karger@karger.ch www.karger.com Original Paper Urol Int DOI: 10.1159/000345711 Is the Percutaneous Nephrolithotomy Procedure Complicated in Patients with Anterior Caliceal Stones? Abdulkadir Tepeler a Omer Faruk Bozkurt b Berkan Resorlu b Mesrur Selcuk Silay a Ekrem Ozyuvali b Cevper Ersoz a Muzaffer Akcay a Tolga Akman a Abdullah Armagan a Ali Unsal b a Department of Urology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, and b Department of Urology, Kecioren Teaching and Research Hospital, Ankara, Turkey prolonged hematuria in group 1. The overall success and complication rates were similar in both groups. Conclusion: Although the postoperative hemoglobin drop did not sig- nificantly differ between groups, hemorrhaging was more severe in patients with anterior caliceal stones than in those with posterior caliceal stones. Copyright © 2013 S. Karger AG, Basel Introduction Since percutaneous nephrolithotomy (PNL) was first performed by Fernström and Johansson [1] in 1976, it has been accepted as a first-line treatment modality for renal stones 12 cm, with technological developments in instru- ments and refinement of the technique [2]. A number of patient-, stone- and operation-related factors that impact the outcomes of endourologic proce- dures have been previously investigated [3–7]. Stone size and complexity are the main factors affecting the out- comes of PNL [3, 8]. Recently, the pelvicaliceal system anatomy (infundibular length and width, infundibulo- pelvic angle and pelvicaliceal surface area) has been a popular subject and has been explored in patients under- going PNL and retrograde intrarenal surgery [9, 10]. The Key Words Renal stone  Percutaneous nephrolithotomy  Anterior calyx  Posterior calyx Abstract Objectives: It was the aim of this study to evaluate and com- pare the outcomes of percutaneous nephrolithotomy (PNL) for the treatment of posterior and anterior caliceal stones. Patients and Methods: We performed a retrospective analy- sis of 86 patients with isolated caliceal stones who under- went PNL between 2011 and 2012. The patients were classi- fied 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 tomogra- phy. 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 postop- erative period because of extensive bleeding. Hemodynam- ics were stabilized with angioembolization in 2 patients with Received: September 10, 2012 Accepted: November 6, 2012 Published online: January 5, 2013 Internationalis Urologia Abdulkadir Tepeler, MD Faculty of Medicine, Bezmialem Vakif University Adnan Menderes Avenue TR–34093 Fatih, Istanbul (Turkey) E-Mail akadirtepeler  @  yahoo.com © 2013 S. Karger AG, Basel 0042–1138/13/0000–0000$38.00/0 Accessible online at: www.karger.com/uin