Comparison of efficacy of percutaneous nephrolithotomy by two different channels in treatment of complicated upper urinarytrant calculi

Objective To compare the efficacy and safety of percutaneous nephrolithotomy by micro channel(MPCNL) and the standard channel(PCNL) in the treatment of complicated upper tract urinary calculi.Methods 1753 patients with complex upper urinary tract calculi from May 2005 to December 2011 were randomly allocated into MPCNL group(1146 cases) and PCNL group(607 cases),separately.The average operation time and hospital stay,first phase semi-staghorn calculi and full staghorn calculi stone clearance rates,serious complications and other indexes were compared.Results In the two groups of 1753 patients,the F16 and F22 channels were successfully established using MPCNL or PCNL.The semi staghorn calculi and full staghorn calculi stone claerance rates in MPCNL group were significantly lower than those in PCNL group(82.14%) vs(94.29%)(P0.05).The stone clearance rate of the remaining parts showed no differences.MPCNL was associated with longer operation time(72.5±18.5) mins vs(34.1±15.0) mins(P0.05),shorter average hospital stay(9.2±1.9) days vs(14.4±3.2) days(P0.05),and lower rate of severe complications(0.96%) vs(2.14%)(P0.05).Conclusions Both MPCNL and PCNL have their own advantages.The standard channel PCNL combined with EMS stone clearance system is highly efficient,suitable for larger pelvic stones,multiple kidney stones,and infective kidney stones.The MPCNL is suitable for upper ureteral calculi,calyceal single stones,less than 2.5 cm renal stones.The MPCNL has lower risk of damage.