Pneumatic combined with ultrasonic lithotripsy in ultrasound-guided percutaneous nephrolithotomy for complicated renal calculi(Report of 180 cases)

Objective:To evaluate the techniques and effects of pneumatic combined with ultrasonic lithotripsy in ultrasound-guided percutaneous nephrolithotomy(the third generation EMS) for the treatment of complicated renal calculi.Methods:A total of 180 patients with complicated renal calculi underwent operations in our hospital from November 2008 to June 2011.The data were retrospectively investigated.There were 25 case pelvocalyceal calculi,135 case mulitiple renal calculi,and 20 case staghorn calculi,including 35 case bilateral renal calculi in and 3 case renal calculi accompainied with pyonephrosis.In ultrasound-guided,a F24 percutaneous working channel for nephroscopy was established.Renal stones were treated with combined pneumatic and ultrasound lithotripsy by using the Litho Clast Master.For treatment of renal calculi accompainied with pyonephrosis(3 cases),ultrasonic powered lithotripter probe with suction was used firstly to clear the liquor puris and calculis fragments with Low-pressure.Then combined pneumatic and ultrasonic powered lithotripter was used to break and clear the calculi.Results:One stage PCNL was successfully completed in all patients.All of the cases were treated in sing-channel except for 8 cases in dual-channel.The operation time ranged from 50 to 120 minutes,average 70 minutes,and the evaluated blood loss ranged from 50 to 300,average 120ml.The one-stage stone clearnce rate was 91.1%(164/180),other 16 cases had residual calculi less than 0.7cm in diameter and received ESWL a month postoperatively.There were no severe intraoperative and postoperative complication occurred.Conclusions:The pneumatic combined with ultrasonic lithotripsy in ultrasound-guided percutaneous nephrolithotomy is safe and effective for the treatment of complicated renal calculi.It is a most idea choice for minimally invasive treatment of complicated renal calculi clinical.