Intrasinusal Pyelolithotomy Combined with Ureteroscopic Pneumatic Lithotripsy in Treatment of Complex Renal Calculi:A Report of 12 Cases

Objective To evaluate the clinical value of intrasinusal pyelolithotomy in combination with ureteroscopic pneumatic lithotripsy in the treatment of complex renal calculi.Methods Twelve patients with complex renal calculi underwent intrasinusal pyelolithotomy.Removal of stones from renal pelvis and renal calyces was performed under direct vision using stone forceps,and ureteroscopic stone fragmentation was performed for the residual stones with pneumatic lithotriptors.Results Intrasinusal pyelolithotomy combined with ureteroscopic pneumatic lithotripsy was successful in all patients.The operative time ranged from 116 to 235 minutes,and intraoperative blood loss ranged from 50 to 350 mL.Complications such as massive hemorrhage,pleural damage,intestinal injury,renal pedicle injury,perirenal infections and secondary hypertension were not observed.Stones were removed at a time in 10 patients,small residual stones were cleared spontaneously 1.5 months after surgery in 1 patients,and residual stones were treated with extracorporeal shock wave lithotripsy in 1 patients.After 3 to 6 months of follow-up,kidney ureter bladder and intravenous pyelography for patients demonstrated that no residual stones were present,hydronephrosis receded,and serum creatinine levels were normal.Conclusion Intrasinusal pyelolithotomy combined with ureteroscopic pneumatic lithotripsy can effectively treat complex renal calculi and minimize renal injury.