Combined percutaneous nephrolithotomy and lithotripsy through flexible ureteroscope in the treatment of staghorn calculi / 国际外科学杂志

ABSTRACT

Objective To summarize the clinical experience of combined single-access minimally invasive percutaneous nephrolithotomy (MPCNL) and lithotripsy through flexible ureteroscope in the treatment of staghorn calculi.Methods Fifty-seven cases of renal staghom calculi underwent combined MPCNL and lithotripsy through flexible ureteroscope.The size of calculi was (2.7 cm×3.3 cm-3.8 cm × 5.2 cm),3.7 cm×4.1 cmon average.Results The success rate of stone fragmentation was 80.7% (46/57) after the first stage of operation,duration of which was 128 min on average.The average loss of blood was 80 mL (20 - 150 mL).Eleven patients with residual calculi in the middle and lower calyx were also underwent the second stage of operation after 5 - 7 days.The average operation duration of the second stage was 57 min and the total clearance rate was 93% (53/57).Four cases had a few of residual calculi with size of 0.4 - 0.8 cm and went on with the treatment of extracorporeal shock wave lithotripsy(ESWL).Two cases were stone-free in the follow-up for 3 months.Conclusion MPCNL combined with with lithotripsy through flexible ureteroscope on the treatment of staghom calculi can decrease the therapeutic risk and complication,increase the rate of stone-free and safety.