Treatment of upper urinary calculi on minimally invasive percutaneous nephrolithotomy (Experience of 858 cases for 1 015 mPCNL)

Purpose:To assess the safety, feasibility and superiority of minimally invasive percutaneous nephrolithotomy(mPCNL) in treating upper urinary calculi. Methods:We retrospectively investigated 858 patients suffering from renal calculi and upper ureteral calculi, who were treated with minimally invasive percutaneous nephrolithotomy from March 2000 to December 2002. Of 858 cases, pelvocalyceal calculi was in 213 cases, upper ureteral calculi in 111 cases, postoperative residual stone in 129 , staghorn calculi in 391, bilateral renal calculi in 14, respectively. Results:Of 858 cases, 90.18% stone free rate was achieved using one stage minimally invasive percutaneous nephrolithotomy. They were treated by 1015 mPCN, Single tract was in 672 renal units, two tracts in 186 renal units, three tracts in 13 renal units, four tracts in 1 renal unit, respectively. Average operative time was 98 munites, average nephrostomy tube stay was 6 days, average hospitalization stay was 14 days. Blood transfusion was performed in 2 patients, Only one case suffered from massive hemorrhage postoperative 10 day, who was cured by selective embolism of renal artery , no major complications were noted in the other patients. Conclusions:Minimally invasive percutaneous nephrolithotomy is safe and effective in treating upper urinary calculi, Compared to open surgery and traditional PCNL,it may offer advantages with respect to less introoperative and postoperative complications , high stone free rate, less invasion, easy recovery and short hospitalization stay. It also has an advantages of treating the patients with residual and recurrent calculi.