Calicecotomy Combined with Trans-renal Parenchyma Pneumatic Lithotripsy for Complicated Staghorn Renal Calculi / 中国微创外科杂志

ABSTRACT

Objective To evaluate the efficacy of calicecotomy combined with trans-renal parenchyma pneumatic lithotripsy for complicated staghorn renal calculi.Methods The severe hydrocalycosis was incised using electrocautery,then pneumatic lithotripsy was performed and the broken stones were taken out.For those patients with stenotic entrance to renal calyces without hydrocalycosis,we stabbed into the stones with the lithotriptic pole(1 mm in diameter) through renal parenchyma and took the broken stones out of the entrance.Results The renal pedicle were not blocked in 19 cases.The operation time was 90-150 minutes,with a mean of 120 minutes.There was no blood transfusion with the blood loss ranging form 100 to 250 ml.The procedures were successful in 17 cases without residual stones after operation;intraoperative residual sand-like calculi were found in 1 case and removed by irrigation and drainage through nephrostomy tube;intraoperative missing calyceal calculi occurred in 1 case and were cleared by extracorporeal shock wave lithotripsy(ESWL).A follow-up for 10-60 months(mean,18 months)in 15 patients showed recurrence in 2 ones,and the stones were removed by ESWL.Conclusions Calicecotomy combined with trans-renal parenchyma pneumatic lithotripsy for complicated staghorn renal calculi has the advantages of less blood loss and definite efficacy.