Efficacy and safety of ultrasound-guided upper-pole access percutaneous nephrolithotomy for the treatment of renal staghorn calculi
10.11659/jjssx.1672-5042.201405010
- VernacularTitle:超声引导下肾上盏径路经皮肾镜碎石术治疗鹿角形结石疗效及安全性分析
- Author:
Gang XU
;
Zhongyi LI
;
Yong ZHANG
;
Zhewei ZHANG
;
Jimin CHEN
;
Chuanjun DU
- Publication Type:Journal Article
- Keywords:
renal staghorn calculi;
upper calyx;
percutaneous nephrolithotomy
- From:
Journal of Regional Anatomy and Operative Surgery
2014;(5):471-473,474
- CountryChina
- Language:Chinese
-
Abstract:
s: Objective To investigate the efficacy and safety of ultrasound-guided upper-pole access percutaneous nephrolithotomy (PCNL) for the treatment of renal staghorn calculi. Methods From October 2008 to July 2012,193 cases of renal staghorn calculi treated with ultrasound-guided upper-pole access PCNL were reviewed. Among the 193 cases,74 cases were complete staghorn calculi while the other 119 cases were partial staghorn calculi, and the calculi diameter was 2. 5 to 9. 0 cm. All the 193 cases were treated through upper-pole ac-cess successfully,70 accesses were accomplished below the 12th rib,while the other 123 accesses were accomplished between the 11th adn 12th rib. Disintegration of the stone was accomplished using Holmium laser. Results The mean operative time was 70 min (45~150 min), single tract was used in 186 cases, and double tracts were used in the other 7 cases. The stone clearance rate for one session was 72. 0%(139/193),and the total stone clearance rate was 88. 1%(170/193). Transfusion was required in 6 patients, while 2 patients with signifi-cant bleeding were treated with selective renal arterial embolization. Hydrothorax occured in 4 patients, and closed thoracic drainage was re-quired in 2 of them. 20 patients had fever, and they recovered after effective antibiotic treatment. No patients had injury to the lung or other viscera. Conclusion Upper-pole access offers optimal visibility and convenience for rigid ureteroscope to achieve a high rate of stone-free status and operating time reduce. Ultrasound guided upper-pole access PCNL should be attempted in selected cases of renal staghorn stone.
