Objective:The best method of treatment of patients with lower calyceal (LC) renal stones remains controversial. In this study, we analysethe safety and efficacy of percutaneous nephrolithotomy (PCNL) in the management of LC stones 10–20 mm in maximum dimension.

Methods:

A retrospective analysis was done in 50 patients having 10–20 mm size lower calyceal renal calculi who were treated bystandard Percutaneous Nephrolithotomy (PCNL) through upper calyceal approach. Chi Square test for statisticalanalysis was done.

Results:

Stone clearance was achieved in 44 (88%) patients while 6 (12%) patients hadsignificant residual fragments (>4mm size). In 40 (80%) patients, PCNL was done through a singlepercutaneous tract while in 10 (20%) patients; additional tracts were made in an attempt to clearthe stones. The duration of surgery ranged from 1 – 2 hours (Mean 1.5 ± 0.49) and postoperativehospital stays varied from 2 – 5 days (Mean 3.5 ± 1.5). Significant haemorrhage (4%), pleural injury(6%) and hydrothorax (8%) were the main complications.

Conclusion: PCNL through upper calyceal access for treatment of complex lower pole renalcalculi offers good stone clearance with chances of increased but manageable thoraciccomplications.