ABSTRACT
Objective To investigate the clinical efficacy and safety of visual standard channel combined with visual ultrafine channel PCNL precision puncture in treatment of complex renal calculi. Methods From June 2015 to October 2016, 48 cases of complicated renal calculi were treated with multi-channel lithotripsy with visual standard channel ultrasonic pneumatic lithotripsy combined with visual superfine channel PCNL precision puncture holmium laser lithotripsy. Including 10 cases of staghorn stone, 38 cases of multiple renal stones. Results 110 channels were established in 48 patients. 4 cases of preoperative renal insufficiency with infection in the puncture found in the pus and stones load larger, intraoperative diarrhea and PCNL simple treatment of obstruction site stones; 44 cases to complete one of the surgery: There were single channel established in every one of 5 cases, and double channels established in every one of 24 cases, three channels in established in every one of 15 cases; There were two cases of surgery in 8 cases and there were 12 new channels established. The average time of unilateral first operation was 75 (35 ~ 125) min. The first clearance rate was 79.2% (38/48), and the total clearance rate of postoperative stone was 87.5% (42/48). 6 cases of residual stone combined with ESWL and drug row of stone, followed up for 3 months, 6 cases of stone row net, the total stone clearance rate of 100.0% (48/48). Two consecutive postoperative no sepsis, bleeding, ureteral injury and other serious complications. Conclusions Visual standard channel combined with visual superfine channel PCNL precise puncture for the treatment of complex renal calculi is safe and effective, with high fruiting rate and low complication, which can be popularized in clinical practice.
ABSTRACT
Objective To explore the application of visible standard channel combined with F4.8 visible puncture percutaneous nephrolithotomy in the treatment of multiple renal calculi. Methods The clinical data of 46 patients with multiple renal calculi from October 2015 to September 2016 were retrospectively analyzed. There were 28 male and 18 female, with a mean age of 42.6 years (aged from 25 to 65 years). Stone diameter 3.0~5.2 cm, average (4.3 ± 0.8) cm. Application of F4.8 visual puncture assisted angioplasty to establish the standard channel, nephrolithotomy combined with ultrasonic lithotripsy treatment in the field of visible stones, then apply the F4.8 visual micro puncture percutaneous nephrolithotomy combined with holmium laser treatment of other parts of the stone, summarizes the channel establishment total time, operation time, blood red protein decreased and stone clearance rate and complication index. Results All cases were successfully established single standard channel under the guidance of F4.8 visual puncture, 24 cases were combined with single ultramicro channel, 16 cases were combined with double ultramicro channels, and the other 6 cases were combined with the three ultra micro channels. Postoperative indwelling single renal fistula, micro channel indwelling fistula, postoperative indwelling F5 double J tube. F4.8 visual puncture established standard channel establishment time (6.8 ± 1.8) min, single F4.8 visible puncture ultra - channel establishment time of (4.5 ± 0.9) min, operation time of (92.0 ± 15.0) min. A stone clearance rate was 91.3% (42/46), a decrease in hemoglobin value of (12.2 ± 2.5) g/L, 8 cases of postoperative fever, given anti-inflammatory treatment improved, 4 cases with residual calyceal stones visible 0.5~0.8 cm, given extracorporeal shock wave lithotripsy combined with postural drainage, stone, 1 months after the treatment of stones were discharged, did not appear Shi Jie, delayed bleeding, adjacent organ injury, ureteral injury cases. Conclusion Visual standard channel combined with F4.8 ultra visible puncture percutaneous nephrolithotomy in treatment of multiple renal calculi has the advantages of reducing the large number of channels, high stone clearance rate, safety, less complications, F4.8 was used to establish the visual puncture channel is more safe and accurate.
ABSTRACT
Objective To explore the application of visible standard channel combined with F4.8 visible puncture percutaneous nephrolithotomy in the treatment of multiple renal calculi. Methods The clinical data of 46 patients with multiple renal calculi from October 2015 to September 2016 were retrospectively analyzed. There were 28 male and 18 female, with a mean age of 42.6 years (aged from 25 to 65 years). Stone diameter 3.0~5.2 cm, average (4.3 ± 0.8) cm. Application of F4.8 visual puncture assisted angioplasty to establish the standard channel, nephrolithotomy combined with ultrasonic lithotripsy treatment in the field of visible stones, then apply the F4.8 visual micro puncture percutaneous nephrolithotomy combined with holmium laser treatment of other parts of the stone, summarizes the channel establishment total time, operation time, blood red protein decreased and stone clearance rate and complication index. Results All cases were successfully established single standard channel under the guidance of F4.8 visual puncture, 24 cases were combined with single ultramicro channel, 16 cases were combined with double ultramicro channels, and the other 6 cases were combined with the three ultra micro channels. Postoperative indwelling single renal fistula, micro channel indwelling fistula, postoperative indwelling F5 double J tube. F4.8 visual puncture established standard channel establishment time (6.8 ± 1.8) min, single F4.8 visible puncture ultra - channel establishment time of (4.5 ± 0.9) min, operation time of (92.0 ± 15.0) min. A stone clearance rate was 91.3% (42/46), a decrease in hemoglobin value of (12.2 ± 2.5) g/L, 8 cases of postoperative fever, given anti-inflammatory treatment improved, 4 cases with residual calyceal stones visible 0.5~0.8 cm, given extracorporeal shock wave lithotripsy combined with postural drainage, stone, 1 months after the treatment of stones were discharged, did not appear Shi Jie, delayed bleeding, adjacent organ injury, ureteral injury cases. Conclusion Visual standard channel combined with F4.8 ultra visible puncture percutaneous nephrolithotomy in treatment of multiple renal calculi has the advantages of reducing the large number of channels, high stone clearance rate, safety, less complications, F4.8 was used to establish the visual puncture channel is more safe and accurate.
ABSTRACT
Objective To investigate the efficacy of percutaneous renal access with balloon dilation for staghorn calculi.Methods Eighty-nine cases with PCNL were enrolled from February 2012 to March 2015.Clinical data including the time for setting the renal access, operation time, residual stone rate, complications were analyzed.Results Eighty-nine cases established nephrostomy tracts successfully.The average time for setting the renal access was (5.7 ± 1.0) min (4-8 min).The average of operation time was (62.6 ± 14.1) min (37-87min).The average of Hemoglobin decline rate was (6.3 ± 2.5)％ (2.8％-16.9％).The residual stone rate was 12.5％.Conclusions PCNL with ballon dilation is a fast, safe and effective means for staghorn calculi.It is worth using for staghorn calculi.