, Volume 46, Issue 3, pp 279–283 | Cite as

Supracostal access for miniaturized percutaneous nephrolithotomy: comparison of supracostal and infracostal approaches

  • Faruk Ozgor
  • Abdulkadir Tepeler
  • Ismail Basibuyuk
  • Onur Kucuktopcu
  • Yunus Kayali
  • Fatih Yanaral
  • Murat Binbay
Original Paper


In this study, we aimed to evaluate the efficiency and safety of supracostal and subcostal approaches during miniaturized percutaneous nephrolithotomy (mPNL). In two tertiary academic centers, we retrospectively analyzed the charts of patients who had undergone mPNL between January 2011 and June 2015 for the treatment of renal stones. Enrolled in the study were 49 patients who had access through the supracostal area (Group 1) and, to serve as controls, 49 patients who were accessed through the subcostal area (Group 2). To avoid potential bias between the groups, the patients were retrospectively matched one-on-one with respect to age, gender, body mass index, ASA score, and size and number of stones. The presence of upper calyx stones and distorted lower calyx anatomy were the most common reasons for performing supracostal access (57.1 and 28.6%, respectively). Access through 11–12 intercostal space was performed in 46 patients (93.9%), and the other three supracostal accesses (6.1%) were performed through the 10–11 intercostal area. The complication rates were 14.3% in Group 1 and 16.3% in Group 2 (p = 0.952). Final stone-free status had increased to 89.8 and 87.8% in Groups 1 and 2, respectively (p = 0.942). Our study demonstrated that mPNL resulted in acceptable stone-free rates whether accessed through either the supracostal or subcostal areas. Moreover, the supracostal approach with mPNL had no negative effect on any intraoperative and postoperative parameters, nor did it increase complication rates.


Hemothorax Intercostal access MiniPNL Percutaneous nephrolithotomy Pneumothorax Supracostal 



Body mass index


Computed tomography


Intravenous pyelography




Percutaneous nephrolithotomy


Shock wave lithotripsy


Flexible ureterorenoscopy


Urinary tract infection


Author contributions

Ozgor F.—Project development and manuscript writing. Yanaral F., Ozgor F.—Data analyzing. Tepeler A.—Manuscript editing. Basibuyuk I., Kayali Y.—Data collection. Kucuktopcu O.—Manuscriptediting. Tepeler A.—Data collection and data management. Yanaral F., Kayali Y.—Data management. Binbay M.—Project development and manuscript editing.

Compliance with ethical standards

Conflict of interest


Ethical standards

Informed consent was obtained preoperatively from all of our patients which were included in our study.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • Faruk Ozgor
    • 1
  • Abdulkadir Tepeler
    • 2
  • Ismail Basibuyuk
    • 3
  • Onur Kucuktopcu
    • 1
  • Yunus Kayali
    • 3
  • Fatih Yanaral
    • 1
  • Murat Binbay
    • 1
  1. 1.Department of UrologyHaseki Teaching and Research HospitalIstanbulTurkey
  2. 2.Department of UrologySen Jorj Austria HospitalIstanbulTurkey
  3. 3.Department of Urology, Faculty of MedicineBezmialemVakif UniversityIstanbulTurkey

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