Percutaneous nephrolithotomy for recurrent or residual renal calculus in patient with a history of open nephrolithotomy

Objective To explore the efficacy and safety of the recurrent or residual renal calculus with a history of open nephrolithotomy treated with percutaneous nephrolithotomy.Methods The data of 48 cases with recurrent or residual renal calculus with a history of open nephrolithotomy from September 2008 to January 2010 were analyzed retrospectively.All patients were treated with percutaneous nephrolithotomy.21 cases were treated with pneumatic lithotripsy,23 cases with combined pneumatic and ultrasound lithotripsy and 4 cases with dual probe ultrasonic lithotripsy.Results All the cases were cured successfully in one stage.39 renal units were cured by one tunnel way,8 renal units by double tunnel and 1 renal unit by multiple tunnel.The average time for whole surgery was 74 min.The average bleeding volume was 138.6 mL.The average hospital stay was 10 days.The calculi clearance rate was 89.58%(43/48) while 3 cases with residual calculus underwent second neohroscopy and 1 case was cued by ESWL.1 case with severe hemorrhage was cured by superselective renal artery embolization.No other complication occurred and no recurrence was found in 3 to 15 months' follow-up.Conclusion Percutaneous nephrolithotomy is an effective and feasible therapeutic option for patients with recurrent or residual renal calculus after open operation for its advantages of less invasiveness and complications,shorter duration for hospitalization and high safety.