Percutaneous nepheolithotripsy with nephroscopic and ultrasonic power for renal and upper ureteral calculi

Objective To evaluate the efficiency and safety of combined lithoclast and ultrasound lithotripsy for the treatment of renal and upper ureteral calculi during percutaneos nephrolithotomy. Methods From August 2006 to November 2007,97 cases of renal and upper ureteral calculi were subjected to percutaneous nephrolithotripsy with pneumatic and ultrasonic power under B-type ultrasound guidance. Clinical data including the feasibility and complication were analyzed retrospectively. Pelvocalyceal calculi were noted in 27 cases,multiple renal calculi in 26, staghorn calculi in 14,bilateral renal calculi in 9.Longitudinal size of calculi was 1.2-6cm. Working channel for percutaneous nephroscopy was established under the guidance of B-ultrasonography. Renal stones were fragmented and extracted by using the Litho-Clast Master(EMS,Switzerland). Results The percutaneous renal access was successfully established under ultrasound guidance in all the patients. Immediate phase I lithotripsy was performed in 93 cases and delayed phase II lithotripsy in 4 cases. Operation time ranged from 50 to 180 minutes,average time was 90 minutes. Average volume of blood loss was 150 ml. Stones were cleared out in 74 of 97 cases(76. 2%)during immediate phase I lithotripsy. Severe complications such as pheumothorax,abdominal organs injury, severe hemorrhage did not occur during nephrolithotripsy. Conclusion Percutaneous nephrolithotripsy with pneumatic and ultrasonic power under B-type ultrasound guidance for treatment of crenal and upper ureteral calculi is effective and safe.