comparison of papillary and non-papillary access to the calyces in patients undergoing percutaneous lithotripsy

Background: the most crucial steps of percutaneous nephrolithotomy (pcnl) are the percutaneous access and dilation of the access route. objectives: this study compared papillary access to the calyx with non-papillary access in patients who underwent pcnl. methods: this retrospective cohort study reviewed the medical records of patients who underwent pcnl between january 2022 and june 2023. a total of 103 patients (55 with papillary access and 48 with non-papillary access) were included in this study. collected data included patient demographics, pre- and post-operative laboratory values (hemoglobin and creatinine), and documented surgical complications (intraoperative and postoperative bleeding, pleural injury, colon injury, urinary leakage, and abscess formation). results: of the 103 patients, 63 were male and 40 were female. the mean age of all pcnl patients was 42.3 ± 8.6 years (range: 20 - 60). the mean body mass index (bmi) was 28.99 ± 5.34 kg/m2 in the papillary group and 26.73 ± 4.03 kg/m2 in the non-papillary group. the mean operative time was 60.72 ± 15.8 minutes in the papillary group and 56.78 ± 11.33 minutes in the non-papillary group. the mean patient weight was 81.5 ± 12.9 kg in the papillary group and 76.08 ± 14.80 kg in the non-papillary group. no statistically significant differences were observed between the groups for these variables (p > 0.05). postoperative hemoglobin decrease, pleural injury, colon injury, infection, stone-free rate, and urinary leakage rates between papillary and non-papillary groups reported no statistically significant differences. conclusions: this study concluded that non-papillary access is a feasible option for pcnl in terms of stone-free status and complication rates.