Percutaneous Nephroscopic Lithotripsy for Bilateral Upper Urinary Calculi / 中国微创外科杂志

ABSTRACT

Objective To evaluate the efficacy and safety of percutaneous nephroscopic lithotripsy for the treatment of bilateral upper urinary calculi. Methods From July 2004 to December 2008,we performed percutaneous nephroscopic lithotripsy under X-ray or ultrasonic guidance for 35 patients with bilateral upper urinary calculi. Of the 35 patients,bilateral renal calculi were found in 18 patients,unilateral renal and unilateral ureteral calculus in 10,bilateral ureteral calculi in 7. Results In 35 patients (70 sides),the calculi was removed through a single tract in 49 sides,through double tracts in 18 sides,and through triple tracts in 3 sides. The mean operation time for unilateral PCNL was 66 min (ranged from 20 to 185 min). The stone-free rate was 80% (56/70) on one session. A second-look stone removal was needed in 8 laterals,and 3 laterals underwent three times of lithotomy. In three sides,a few residual renal stones were found after the first operation,but no second operation was performed. The final stone-free rate was 91.4% (64/70) in all of the cases,among which the stone-free rate was 100% (24/24) for ureteral stones and was 87% (40/46) for renal stones. In this series,no chest or abdominal injuries,intestinal perforation,or injuries to surrounding organs were detected. The patients were discharged from hospital in 5 to 30 days,and then were followed up for 3 to 6 months. During the follow-up,B-ultrasonography and KUB+IVP found no recurrence of calculi. Conclusions Percutaneous nephrolithotomy is effective and safe for bilateral upper urinary calculi. By skilled urologists in conditioned hospital,simultaneous bilateral percutaneous nephrolithotomy performed on bilateral upper urinary calculi can shorten the cycle time of treatment and hospitalization.