Therapeutic effect of minimally invasive percutaneous nephrostolithotomy in treatment of kidney calculi and influence of renal function

Abstract

Objective To investigate the therapeutic effect of minimally invasive percutaneous nephrostolithotomy (mPCNL) in treatment of kidney calculi and the influence of renal function.Methods According to the operation method,70 patients with kidney calculi were divided into mPCNL group (38 patients) and percutaneous nephrostolithotomy (PCNL) group (32 patients).The curative effect,serum creatinine (SCr) and blood urea nitrogen (BUN) postoperative 1 month were compared.Results The patients in two groups were successfully for broken calculi.The operation time of stag-horn calculi,retinitis simplex kidney pelvis calculi and kidney calices multiple calculi in PCNL group were significantly shorter than those in mPCNL group [(89.13 ± 13.36) min vs.(112.32 ± 12.41) min,(65.28 ±9.76) min vs.(78.84 ± 12.03) min,(98.97 ± 11.84) min vs.(112.64 ± 10.87) min,P ＜ 0.05].The first stage clearance rate of retinitis simplex kidney pelvis calculi in PCNL group was significantly higher than that in mPCNL group [88.89％(8/9) vs.57.14％(8/14),P ＜ 0.05].But the clearance rate of kidney calices multiple calculi in PCNL group was significantly lower than that in mPCNL group [58.33％(7/12) vs.86.67％(13/15),P＜0.05].The first stage clearance rate of stag-horn calculi in two groups had no significant difference [63.64％(7/11) vs.66.67％ (6/9),P ＞ 0.05].The patients in two groups had no serious complication.The rate of fever after operation in two groups had no significant difference [15.63％ (5/32) vs.10.53％ (4/38),P ＞ 0.05].The level of SCr and BUN in the patients combined with kidney insufficiency in two groups were decreased slightly (P ＞ 0.05).The improvement rate of renal function in two groups had no significant difference (P ＞0.05).Conclusions mPCNL and standard channel PCNL in treatment of kidney calculi can achieve a good first stage clearance rate,and the incidence rate of postoperative complication is lower.mPCNL and standard channel PCNL have no obviously influence on early stage renal function.The operation time of mPCNL is generally longer,but the therapeutic effect of kidney calices multiple calculi is better than standard channel PCNL. Key words: Kidney calculi; Renal insufficiency; Nephrostomy,percutaneous; Surgical procedures, minimally invasive