Minimally Invasive Percutaneous Nephrolithotripsy by Holmium Laser for Patients with Kidney Calculi and Upper Ureteral Calculi:Report of 708 Cases

Objective To evaluate the validity,superiority and security of minimally invasive percutaneous nephrolithotripsy by holmium laser(MPCNHL) on the treatment of renal calculi and or upper ureteral calculi. Methods From Nov 2005 to Feb 2011,708 cases with renal calculi and(or) upper ureteral calculi were treated by MPCNHL.After dilating the access,a Peel-away sheath was inserted.Under an ureteroscope the calculi were fragmented by holmium laser and removed once or several times. ResultsAll cases were successful,no one transferred into open operation,the success rate was 100%.From 430 cases with renal calculi(included 87 cases with two-sides renal calculi),145 cases were removed complete calculi once time,218 cases twice,21 cases thrice,and 9 cases were removed calculi four times.The stone clearance was 91%.the pyelic obstruction rate was 100%.From 198 cases with upper ureteral calculi(included 23 cases with two-sides ureteral calculi) all were cleaned calculi completely once time,the stone clearance was 100%.Eighty cases with renal and ureteral calculi,the stone clearance was 94%.The mean operation time was 73min(ranged 15-128min),no cases needed blood transfusion,and without pyelic and ureter perforation. ConclusionsMPCNHL is a safe and effective surgical technique on treatment of renal calculi or upper ureter calculi,which has less invasive with short recovery time,and is worthy of being spreaded.