Experience and modification of percutaneous nephrolithotomy for caliceal diverticular calculi / 中华泌尿外科杂志

ABSTRACT

Objective To summary our experiences in percutaneous nephrolithotomy for treating the caliceal diverticular calculi and postoperative outcome with technical modification.Methods A retrospective review was performed on 34 patients with caliceal diverticular calculi who underwent percutaneous nephrolithotomy between January 2009 and June 2013.The patients were divided into 2 groups.In group A (1 1patients),stones were removed and diverticular neck was incised.In group B (23 patients),fulguration of diverticular wall was performed after the stone removal and diverticular neck incision.Group A had 11 cases including 4 male and 7 female with average age (36.7± 16.0) years.Mean size of stone was (1.8±0.4) cm.Mean maximum diameter of diverticulum was (2.3±0.5) cm.Group B had 23 cases including 10 male and 13 female with average age (40.1±12.0) years.Mean size of stone was (1.9±0.6) cm.Mean maximum diameter of diverticulum was (2.3±0.8) cm.There were no significant difference in stone size and maximum diameter of diverticulum within two groups (P＞0.05).The following parameters such as operative time,drop in hemoglobin,stone clearance,complication rate and ablation rate of diverticulum were compared between two groups.Results In group A,average operative time was (62.7±11.7) min.Mean hemoglobin dropping was (12.0t9.7) g/L.Stone clearance rate was 90.9％ (10/11) and overall complications rate was 18.2％ (2/11).The ablation rate of diverticulum was 63.6％ (7/11).In group B,average operative time was (76.3±21.6) min.Mean Hemoglobin reducing was (12.9±16.7) g/L.Stone clearance rate was 91.3％(21/23) and overall complication rate was 21.7％.The ablation rate of diverticulum was 91.3％ (21/23).There was no significant difference in stone clearance and complication rate between two groups.It seemed that the operativc timc in group B was longer than that in group A.However,no significant difference was found (P＞0.05).The ablation rate of diverticulum in group B was significantly higher than that in group A (P＜0.05).Conclusion In percutaneous nephrolithotomy treatment for caliceal diverticular calculi,fulguration to diverticular wall is an effective method to achieve diverticular obliteration and reduce possibility of stone recurrence.