Telescopic renal sheath in percutaneous nephrolithotomy of complex kidney stones / 中国医师进修杂志

ABSTRACT

Objective To demonstrate a simple and cost-effective method to develop a telescopic renal sheath for treatment of complex kidney stones in percutaneous nephrolithotomy. Methods From October 2013 to October 2017, the clinical data of 94 patients with complex kidney stones and renal calyx diverticulum calculi who had underwent percutaneous nephrolithotomy were collected and were divided into two groups according with operation methods. In group A (45 patients), the 16F Peel-away sheath was inserted into the 20F outside sheath as the inner sheath. The stones were fragmented and removed through the telescopic renal sheath. In group B (49 patients), the stones were fragmented and removed through the 20F Peel-away sheath. The blood lose (hemoglobin decrease), operation time, rate of stone clear and perioperative complication between two groups were compared. Results All patients completed operation. The operation time in group A was significantly shorter than that in group B:(75.9 ± 15.8) min vs. (87.1 ± 21.6) min, P＝0.005. The decreased level of hemoglobin was less than that in group B: (0.72 ± 0.57) g/L vs. (1.22 ± 1.13) g/L, P＝0.009. The rate of stone clear in group A was higher than that in group B: 93.33%(42/45) vs. 77.55%(38/49), P＝0.032. All patients in group A had mild hematuria, which resolved within 2 d, and none received blood transfusion.Two patients in group B received blood transfusion. A small proportion in group A (1/45) and group B(4/49) received perioperative anti-infection therapy and fever rates were similar in the two groups. There were no serious complications such as pneumothorax and intestinal injury. Conclusions Telescopic renal sheath in mini-percutaneous nephrolithotomy is an effective method to treat complex kidney stones and renal calyx diverticulum.