Percutaneous Nephrolithotripsy with Pneumatic and Ultrasonic Power for Treatment of Complicated Renal Calculi

Objective To evaluate the efficacy and safety of management of complicated renal calculi by percutaneous nephrolithotripsy(PCNL).Methods By analyzing 156 cases of complicated renal stone performed by percutaneous nephrolithotripsy from September 2004 to August 2007.A stent was first inserted into the pelvis through cystoscope,and normal saline was slowly injected to dilate collecting system.Antegrade percutaneous access was obtained by X-ray perspective or B-type ultrasound guidance.A combination pneumatic and ultrasonic lithotrity was used to disintegrate and remove stone under direct vision.Clinical data including operation time,complications and stone free rate were analyzed retrospectively.Results The percutaneous renal access was successfully established in all patients,immediate phase I lithotripsy was performed in 148 cases and delayed phase II lithotripsy in 8 cases.Operation time ranged from 50 to 110 minutes,average time was(82±9)minutes,and 3 cases were supported by blood transfusion,severe complications such as pneumothorax did not occur during nephrolithotripsy.Stones were cleared in 135 out of 156 cases(86.53%)during immediate phase I lithotripsy,residual stone fragment was found in 21 cases who received second PCNL or adjuvant extracorporeal shock wave lithotripsy.Conclusion PCNL appears to be an efficacious and safe treatment for patients with complicated renal calculi.