Percutaneous nephrolithotomy, Upper pole calyx, Subapical puncture, Renal stones, Surgical outcomes, Diseases of the genitourinary system. Urology, RC870-923

Abstract Background This study aims to evaluate the effectiveness of upper pole calyx fornix subapical puncture in percutaneous nephrolithotomy (PCNL) compared to traditional middle calyx puncture. The subapical puncture technique offers the advantages of upper pole access while minimizing the risk of pleural injury. Methods We conducted a retrospective analysis of 194 patients who underwent PCNL at our hospital from May 2022 to November 2023. Patients were divided into two groups based on puncture technique: the Upper-PCNL group (n = 122) with upper pole calyx fornix subapical puncture and the Mid-PCNL group (n = 72) with middle calyx fornix apex puncture. Data collected included tract establishment time, operative time, stone-free rates, complications, and auxiliary procedures. Results The Upper-PCNL group demonstrated significantly higher primary stone-free rates (83.6% vs. 69.4%, P = 0.021) and shorter operative times (59.99 ± 5.85 min vs. 68.49 ± 6.74 min, P