Clinical experience of standard–tract percutaneous nephrolithotomy for upper urinary tract calculi

Abstract

Objectives To evaluate the efficacy and safety of standard–tract perentaneous nephrolithotomy(PCNL) for upper urinary tract calculus. Methods We retrospectively analyzed the dates of 418 patients who had underwent PCNL in our department from January 2005 to June 2014.92 cases of them were upper ureteral calculi, 132 cases were single renal calculi, 152 cases were multiple renal calculi, 42 cases were staghorn calculi.The meas calculus size was 2.4cm×3.5cm (range 1.0cm×1.4cm~3.5cm×8.7cm).314 cases were hydronephrosis.92 cases were renal dysfunction.418 caces of patients underwent standard–tract percutaneous nephrolithotomy. Results All patients were performed PCNL successfully.299 cases were cured by one channel way, 97 cases were treated by double channel, and 22 cases were treated by three channel.Stone free rate after a single PCNL was 84.69%.The average time for whole surgery was 86 (25~210)min, 46 cases of 53 were given extracorporeal shock–wave lithotripsy (ESWL).3 cases was given super–selection renal artery embolism for bleeding after operation. Overall 40 cases developed postoperative complications, including postoperative high fever in 37 cases, septic shock in 3 cases.All patients were followed up for 1~24 months.No complications were found.66 cases with renal dysfunction recovered, and 19 cases improved to some degrees. Conclusions PCNL for the treatment of complex upper urinary tract calculi is effective and safe, with little trauma and less complication, and is worthy of promoting. Key words: Urinary Calculi; Nephrostomy, Percutaneous; Lithotripsy