RESUMO
Objective To find a safe and effective management for upper ureteral calculi after failure of extracorporeal shock wave lithotripsy(ESWL).Methods Under a F20.8 endoscope(EMS Ⅲ,Switzerland),percutaneous nephrolithotripsy was performed with pneumatic and ultrasonic power on 43 patients with upper ureteral calculi after having been treated by ESWL for 1 or 2 times.Results The procedure was completed in 42 of the patients with a mean operation time of 60 min(35 to 75 min),mean time for calculi removal of 12 min(5 to 20 min),and mean blood loss of 50 ml(20 to 150 ml).One patient was converted to open surgery because of failure of percutaneous renal puncture.One patient developed haematoma after the procedure and then was cured by conservative therapy without receiving blood transfusion.One patient had fever due to infection and was cured after antibiotic therapy.42 patients were followed up for 2 to 18 months(mean,6.4 months);none of them had massive hemorrhage,infection,hydronephrosis,or recurrence of the calculi during the period.Conclusions Percutaneous nephrolithotripsy with pneumatic and ultrasonic power is safe,minimally invasive,and effective for upper ureteral calculi after failure of ESWL.