Title: Treatment of upper urinary calculi with MPCNL: experience in 2,724 cases
Abstract: Objective To evaluate the effacacy of minimally invasive or micro-invasive percutaneous nephrolithotomy( MPCNL) in treating upper urinary calculi. Methods A retrospective analysis was performed on 2,724 patients received MPCNL in our department from January 2004 to December 2013. Results During the treatment,2,835 kidneys were treated and MPCNL was performed for3,078 times,including first stage procedures for 2,696 times( 87. 59%),secondary procedures for 357 times( 11. 60%) and third procedures for 25 times( 0. 81%). Nephrolithotomy was performed in 2,786 cases( 98. 27%) via single tract,in 44 cases( 1. 55%) via double tracts and in 5 cases( 0. 19%) via triple tracts. After,173 cases( 6. 35%) needed extracorporeal shock wave lithotripsy( ESWL) and / or flexible ureteroscope lithotripsy. The average operating time was( 120. 4 ± 50. 5) min. The stone-free rate after MPCNL was91. 2%,and it was increased up to 94. 1% by adjunctive ESWL and / or flexible ureteroscope lithotripsy. And the mean hospital stay was( 10. 6 ±3. 2) days. Blood transfusion was performed in 61 cases( 2. 24%) including 8 cases( 0. 29%) that needed selective renal arterial embolization to achieve hemostasis. Other complications included 1 case( 0. 04%) of kidney rupture caused by nephrectomy,1 case( 0. 04%) case of colon injury,and 5 cases( 0. 18%) of pleura injury. Septic shock happened in 28 cases( 1. 03%),one of which( 0. 04%) died. Another death was caused by pulmonary embolism seven days after operation. Conclusion MPCNL has the advantage of less invasion and complications and higher stone-free rate. The clinical experience in MPCNL demonstrates that it is safe,feasible,and efficient for managing upper urinary calculi.
Publication Year: 2015
Publication Date: 2015-01-01
Language: en
Type: article
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