Treatement of upper urinary calculi with Holmium:YAG laser lithotripsy under mini-percutaneous nephrolithotomy (A report of 38 cases)

Objective To evaluate the feasibility and availability of mini-percutaneous nephrolithotomy (m-PNL) and Holmium: YAG laser in treating upper urinary calculi. Methods Percutaneous nephrostomy was established solely under the guide of B-ultrasound. The renal tract was dilated to 18F in diameter. A total of 38 patients suffering from upper urinary calculi were treated with m-PNL and Holmium:YAG laser. Of the 38 cases,renal calculi was found in 35 cases and upper ureteral caculi in 3. A 8.0/9.8 F ureteroscope and Holmium: YAG laser were used through a peelaway sheath to manage the calculi. Results The average hospital stay was 10 days,the average time of blood urine was 2.5 days. 32 cases underwent one-stage procedure,another 6 cases underwent two stages. No case changed to open operation during the procedure. The mean operation time was 2.0 hours. 84.2% renal calculi were disappeared after procedure,2 patients underwent ESWL for residual fragments. Single tract was found in 35 cases,two tracts in 3 cases. Conclusions Mini-percutaneous nephrolithotomy is safe and effect in treating upper urinary complex calculi,with high stone free rate,less invasion,little complications and easy recovery. It is highly recommended.