Treatment of complicated renal calculi under percutaneous nephrolithotomy with ultrasonic and pneumatic lithotriptor

Objective:To evaluate the clinical efficacy of percutaneous nephrolithotomy with ultrasonic and pneumatic lithotriptor for the complicated renal calculi.Methods:The present study includes 48 cases of patients with complicated renal calculi who received percutaneous nephrolithotomy that had been preformed with ultrasonic and pneumatic lithotriptor (EMS III,Switzerland).Of these 48 cases,complete staghorn calculi were noted in 12 cases, partial staghorn calculi in 30 cases, multiple calculi in 6 cases. The mean diameter of calculi was 2.8 cm (range from 2.0 to 6.5 cm).Results:The stones were cleared out in 43 out of 48 cases.Other 5 cases of complete staghorn calculi were treated by ESWL due to residual stones(diameter1.0 cm) after two months of operation,then the residual stones were discharged completely.All stones were fragmented and the stone clearance rate was 89.6% (43/48). The operative duration was 50~120 minutes,averaged 70 minutes.No obvious complications were observed. The average intraoperative blood loss was 50 ml.The renal function had demonstrated some extent improvement during the follow up period of 3~6 months.Conclusions:Percutaneous nephrolithotomy with ultrasonic and pneumatic lithotriptor (EMS 3) for complicated renal calculi has the advantages of high efficacy,reliability,safety,mini invasion,less haemorrhage and rapid recovery.It should be the first choice for complicated renal calculi at present.