Percutaneous nephroscopic lithoclast and ultrasound lithotripsy for complicated renal calculi

Objective:To evaluate the efficiency and safety of combined lithoclast and ultrasound lithotripsy for the treatment of complicated renal calculi.Methods:From August 2004 to June 2006,we retrospectively investigated 55 patients suffering from complicated renal calculi,who were treated with combined lithclast and ultrasound lithotripsy during percutaneous nephroscopy.Pelvocalyceal calculi were noted in 25 cases,multiple renal calculi in 18,staghorn calculi in 12,bilateral renal calculi in 7.Longitudinal size of calculi was 3-7 cm.Working channel for percutaneous nephroscopy was established under the guidance of B-ultrasonography.Renal stones were fragmented and extracted by using the LithoClastMaster(EMS,Switzerland).Results:All cases except a pyonephrosis were underwent one-stage minimally invasive percutancous nephrolithotomy by single tract.The average time for whole surgery was 120 minutes.Average volume of blood loss was 200 ml.The stone clearance rate was 70.9%.During the follow-up period of 1 to 22 months,no severe complications,such as hemorrhage or renal function deterioration,were observed.Conclusions:The combined lithclast and ultrasonic device is safe and effective for the treatment of complicated renal calculi.