A combined pneumatic and ultrasound lithotripsy during percutaneous nephrolithotomy under type B ultrasound guidance for the treatment of complex upper urinary calculi

Objective To investigate the clinical efficacy of combined contact pneumatic and ultrasound lithotripsy during percutaneous nephrolithotomy under ultrasound guidance for the treatment of complex upper urinary calculi.Methods From January 2009 to August 2009,56 renal units in 51 patients underwent percutaneous nephrolithotomy using a combined pneumatic and ultra-sonic lithotrite via ultrasound guidance for treatment of complex upper urinary tract calculi.Clinical data was analyzed retrospectively.Results All the cases was cured successfully in one stage.Fifty renal units were cured by one tunnel way,4 renal units by double tunnel,and 2 renal units by multiple tunnels.The average time for whole surgery was 85 min.The calculi degradation rate was 100% and the calculi clearance rate was 87.5%(49/56)while 7 cases had a residual calculi smaller than 1.0 cm in diameter due to an inaccessible location.These 7 cases were cured by ESWL or drug treatment.No complication occurred during 1 to 3 months'follow-up.Conclusions The value of PCNL under ultrasound guidance for the treatment of complex upper urinary tract calculi is accurate locat-ing,the construction of tunnel is safe and convenient.A combined pneumatic and ultrasound lithotripsy device deal with complex upper urinary tract calculi during percutaneous nephrolithotomy appears to be efficacious and safe for calculi clearance with less compli-cations.