ABSTRACT

Background: Percutaneous nephrolithotomy (PCNL) is the gold standard for treating kidney stones larger than 2 cm in diameter. The first and most significant step in doing a PCNL is to create percutaneous renal access. The progressive descent and bull’s-eye techniques of operation are the two basic strategies for obtaining suitable percutaneous renal access under fluoroscopic surveillance. In this article, the rates of success and complication for these two surgeries are compared. The Aim of the Study: The objective of the research is to make a comparison to the results and morbidities of patients who had percutaneous nephrolithotomy (PCNL) using the progressive descent strategy to those who had bulls-eye PCNL. Patients and Methods: Between October 2019 and May 2021, 200 patients with simple renal stones were haphazardly specified to one of these groups depending on the percutaneous renal access method employed for PCNL. The bulls-eye strategy was utilized on patients in group 1 (n = 100), whereas the steady descent method was employed on patients in group 2 (n=100) Patients who required several access points were thrown out of the study. The results of the preoperative, surgical, and postoperative follow-ups were assessed and compared. Results: No significant variation was noticed in patient demographics among the groups (stone size, body mass index, mean patient age, or stone location). The operation time was shorter for the slow descent method, the fluoroscopic screening time (FST) was shorter for the slow descent method, and the length of hospitalization was equivalent in both groups. Those in Group 1 had a larger postoperative drop in hematocrit than patients in Group 2.The rate of blood transfusion, however, was comparable in both groups (7.5 percent). Despite the fact that group 1 had a larger complication rate than group 2, no meaningful difference was found. Conclusions: The current research indicates that PCNL can be safely made by emplyong a pair of access techniques: the slow descent technique less operative time and less radiation exposure time. There was a correlation between both access techniques and comparable hospital stays as well as success and complication rates. Because the access tract was properly aligned with the infundibulum throughout the gradual descent, there was less blood loss and less force needed to be applied.