Percutaneous nephrolithotomy with holmium laser for upper urinary calculi (Experience of 412 cases)

Aim To assess the efficacy and safety of the holmium laser with percutaneous nephrolithotomy for upper urinary calculi.Methods A restrospective investigation was made on 412 cases with upper urinary calculi,who were treated with percutaneous nephrolithotomy with the holmium laser from October 2004 to October 2009.After retrograde placement of the ureteral catheter,a track from the skin surface into the renal calyx was established under the guidance of X-Ray(77 cases) and B-type ultrasonography(335 cases).After dilation,the sheath from 18F to 26F was passed in,and then,rigid ureteroscopy or nephroscopy was passed to introduce a holmium laser lithotriptor.Stones were broken up and a nephrostomy tube was placed in the incision to carry fluid from the kidney.Results Holmium laser percutaneous nephrolithotomy was completed in the first stage of treatment in the 391 cases,and was achieved in the second stage of treatment in 21 cases.In 412 cases,392 cases were treated by single-tract nephrolithotomy and 20 cases were treated by double-tract nephrolithotomy.The stone-free rate was 87.7%.The average operation time was 130 min.The nephrostomy tube was left for 5 days.The length of postoperative hospital stay was 6.5 days.Conclusion Holmium laser percutaneous nephrolithotomy is safe and effective in the treatment of upper urinary calculi.