Treatment of Upper Urinary Calculi with Stage II Invasive Percutaneous Nephrolithotomy

Objective: To evaluate the feasibility and efficacy of stage II invasive percutaneous nephrolithotomy(PCNL) in treating upper urinary calculi.Method: The data of 1052 patients with upper urinary calculi who had stage II PCNL were analyzed.Of the 897 cases with nephrolithiasis,501 cases had kindey pelvis and multiple renal calyceal calculi,334 cases had staghorn calculi,and 62 cases had bilateral renal calculi,118 cases combined with upper ureterolithiasis calculi.There were 155 cases with simply upper ureterolithiasis.The stone size ranged from 1.0cm×0.6cm to 7.5cm×3.5cm.278 cases had slight hydronephrosis,and 454 cases had moderate and severe hydronephrosis.16 cases combined with pyonephrosis,and 45 cases combined with obstructive renal failure.Result: All of the the cases underwent stage I percutaneous nephrostomy,and then stage II PCNL.The procedure was performed by single tract in 936 cases,and by two tracts in 116 cases.Lithotomy was done by one session in 895 cases,by two sessions in 82 cases,and by three sessions in 8 cases.The total stone clearance rate was 93.6%.The mean operative time was 103minutes,and mean hospital stay was 13.6 days.Average volume of blood loss was 40.7mL,There were 26 cases with high fever(39℃) postoperatively.Four cases with pneumothorax,and 1 case with hemorrhage.Conclusion: Stage II PCNL has advantages of minimal trauma,less blood loss,fever complications,and is safe and effective in treating upper urinary calculi,especially for patients combined with pyonephrosis,obstructive renal failure and so on.