Résumé
Objective To discuss the efficacy of minimally invasive percutaneous nephrolithotomy(MPCNL) for residual or recurrent stones in the kidney or upper ureter after open surgery.Methods A total of 46 cases of residual or recurrent stones in the kidney or upper ureter after open surgery were included in the study.A pigtail catheter was inserted into the ureter transurethrally under ureteroscope to create an artificial hydronephrosis.Then a renal fistulization,usually on middle or upper calyx,was made.The stones were identified under ureteroscope,fragmented with a pneumatic ballistic lithotriptor,and extracted by using a grasping forceps.The renal fistulization tube was indwelled for drainage.Results The stones were completely removed on one session in 20 cases(43.4%),on two sessions in 15 cases(32.6%),and three in 8 cases(17.3%).Residual stones were seen in 3 cases(6.5%),with a size of 0.1 cm ? 0.1 cm ? 0.2 cm ～ 0.5 cm ? 0.5 cm ? 0.6 cm.Stones were removed through one working channel in 18 cases(39.1%),two channels in 20 cases(43.5%),and three channels in 8(17.4%).Conclusions The MPCNL is miuimally invasive and effective in the treatment of residual or recurrent stones after open surgery.