Title: MPCNL with irrigation and clearance system treatment urinary tract stones:Report of 858 cases
Abstract: Objective:To investigate the safety and efficacy of MPCNL with irrigation clearance system.Method:A retrospective analysis 858 patients underwent MPCNL with patent sheath and irrigation clearance system.From August 2008 to April 2011.There were 626 cases of renal stones(including 32 cases with bilateral renal calculi,302 cases of staghorn calculi) with an average stone burden of(8.57±2.25) cm2;there were 232 cases of upper ureteral stones complicated by hydronephrosis(including 65 cases of bilateral upper ureteral stones),with an average stone burden of(1.16±0.25) cm2.There were 86 cases complicated by pyonephrosis and 65 cases had a history of open surgery to remove the stones.The patient was placed in a flat prone position without boosting the abdomen to prevent the fixation of the kidneys.The MPCNL was performed after establishing a percutaneous tract under the guidance of B ultrasound combined with KUB and CT images,with the aid of the patented system.The lithotripsy was performed using a high-powered holmium laser.Result:Percutaneous tracts were established successfully in all 858 cases,in which stones were located in 955 sides.There were 915 sides that had lithotripsy on the first surgery and 40 sides that underwent a second-stage lithotripsy due to complicated pyonephrosis.There were 843 sides in which a single percutaneous tract was used,54 sides in which double percutaneous tracts were used,and 18 sides in which 3 percutaneous tracts were used.The average time in establishing a percutaneous tract was 3.2 min.The average stone clearance time was 45.4 min for kidney stones and 9.3 minutes for ureteral stones.Stone clearance by one surgery was 91% for kidney stones(599/658 sides) and 100% for ureteral stones(297/297 sides).Stone clearance rate after supplemental therapies was 96.8 %(599/658 sides) for kidney stones.The average amount of bleeding was(55±23.1) ml.The percentage of cases needing blood transfusion was 1.75%(15/858).The percentage of cases needing interventional embolization to stop bleeding was 0.69%(6/858).The percentage of cases that had postoperative fever was 3.8%(33/858).The percentage of cases that had irrigation fluid extravasations was 2.1%(18/858).There was no case that had injury to surrounding organs during the surgery.Conclusion:MPCNL with irrgation clearance system is a minimally invasive,quick,safe surgical procedures.and significantly reduced bacteremia,sepsis and other complications.
Publication Year: 2012
Publication Date: 2012-01-01
Language: en
Type: article
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