Percutaneous Nephrolithotomy Combined with Extracorporal Shockwave Lithotripsy in the Treatment of Staghorn Renal Calculi

Objective:To evaluate the clinical effects of percutaneous nephrolithotomy(PCNL) combined with extracorporal shockwave lithotripsy (ESWL) in the treatment of staghorn renal calculi.Methods: The clinical data of 48cases(33 males and 15 females ) treated by PCNL combined with ESWL were retrospestively analyzed.There were mono-ranal caculi in 38 patients (3 patients were the isolatedrenal calculi ) while the other 6 combined opposite side upper urinary stract calculi.4 patients were the un-hydronephrotic cata-staghorn real calculi .The diameter of calculi ranged from2.7 to 5.4(mean=4.3)cm. All were treated by PCNL combined with ESWL.Results: 39 cases (81.3%)were curde by ESWL combined with PCNL.9 cases(18.7%)were leftover calcnli.All the 48 patients were followed up for 6 to 38 months. None of them had nephrohydrops or stenosis.Three(7.7%,3/39)had calculus recurrence in 39cases which calculi were completely removed before .The size and amount of leftover calculi in 2 patients(22.2%,2/9)were increasing. Renal function reinvestingation showed that 5 patients recovered and 2 improved in the 7 patients who had azotemia before.Conclusion: PCNL combined with ESWL may substituethe open operation and is the preferrded method for staghom remal calculi.