Stage I minimally invasive percutaneous nephrolithotomy for calculi complicated with pyonephrosis

Abstract

Objectives To evaluate the safety and efficacy of stage-Ⅰ minimally invasive percutaneous nephrolithotomy (MPCNL) for the treatment of upper urinary calculi complicated with pyonephrosis.Methods From January 2012 to June 2013,a total of 26 patients with upper urinary calculi complicated with pyonephrosis were treated with stage · Ⅰ MPCNL.Of the patients,8 had upper ureteral calculi,9 showed calculi in both kidneys,13 suffered from renal pelvis calculi.Of the patients,11 complained of low back pain at the affected side,5 had fever before operation,9 assumed bacteria culture positive in midstream urine.Results The mean operation time was 49.2 ± 13.2 minutes in our patients.The stones were removed on one session in 22 cases(80.8 ％).Mean hospital stays was 8.38 ± 0.98 days.Six patients confirmed bacteria culture positive in urine in the kidney pelvis,1 patient confirmed positive blood culture after surgery.Eight patients appeard postoperative fever (Greater than 38 degrees Celsius),up to 39.6 degrees Celsius.Of the patients,2 had a transient fever,4 had a persistent fever last 1 to 3 days and 2 had a persistent fever last 4 to 5 days.Conclusions Stage-Ⅰ MPCNL is an effective,quick-recovery and safe treatment for upper urinary calculi complicated with pyonephrosis,as long we stick to the indications and standard procedures for the operation. Key words: Kidney Calculi ; Nephrostomy, Percutanous