Several strategies of increasing the stone-free rate of staghorn calculi by percutaneous nephrolithotomy
Zhong Dongliang
WuYuji
LiuGuanzhao
WuWenqu
Abstract：Objective:To summarize the strategies of increasing the stone-free rate of staghorn calculi by per-cutaneous nephrolithotomy (PCNL).Methods:Eighty-three cases of staghorn calculi were subjected to kidney non-contrast CT (NCCT)scan preoperatively.During PCNL,two F5 ureteral catheters were indwelled when the expansion of the ipsilateral ureter was found,together with a suction device if preoperative diagnosis of urinary tract infection was done or cloudy urine or merge multiple tiny stones were found intraoperatively.Pneumatic lith-otripsy device was used to shatter stones orderly.The C-arm was used to check the residual stones before the end of operation.KUB radiography was carried out to statistically analyze the stone free-rate 2-4 days postoperation. Results:After the first stage PCNL,56 cases of staghorn calculi were removed completely (67.5%,56/83).The mean operative time was 81 min (28-142 min),and mean hemoglobin decrease was 23 g/L (0-54 g/L),In one case of postoperatively declined hemoglobin,renal arteriography and super selective embolization were done.Seven cases had fever postoperation.No urosepsis and organ inj ury occurred.There was no death.Conclusions:Kidney NCCT scan preoperation,two ureteral catheters,if necessary,together with a suction device,orderly shatter stone,the C-arm used to confirm residual stone before the end of PCNL,all of above comprehensive measures can increase the stone free-rate of staghorn calculi by PCNL.
Keywords：staghorn calculipercutaneous nephrolithotomystone-free ratesnegative pressure systemnon-contrast CT
Publication Date：2016-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 218-221 )