Percutaneous nephrolithotomy for upper urinary tract calculi in patients with deformity of spine / 中华泌尿外科杂志

ABSTRACT

Objective To evaluate the efficacy and safety of standard percutaneous nephrolithot-omy (PCNL) for patients with deformity of spine. Methods Between Aug 2003 and May 2009, 35 patients of upper urinary tract calculi with scoliosis and kyphosis had undergone PCNL accessed by two steps dilation to 24F tract with ultrasound guidance. Clinical data were analyzed retrospectively. Results The pereutaneous renal access was successfully established in 35 patients under ultrasound guidance and immediate lithotripsy was performed. Prone position 9 units,lateral position 14 units,and other unconventional position 14 units. 34 (91.9 %) units were operated by single access and 3 (8.1%) by double in one session. The mean first accessing time was (8. 5±1.7)min, and stone management time was (39.3±14.6)min. The stone-free rate after the first operation was 86.5%, 2 kidneys ac-cepted another PCNL to remove the residual calculi, and the last stone-free rate was 91.9%. 2 cases needed transfusion. No injury of adjacent organs or urosepsis occurred. No severe complications oc-curred. Conclusions Standard PCNL for calculi in patients with deformity of spine accessed by two steps dilation to 24 F tract with ultrasound-guided puncture could be effective and safe. Special indi-vidual operative position and experienced clinical technique are needed.