ABSTRACT
Objective To evaluate the efficacy and safety of retroperitoneal laparoscopic pyelolithotomy ( RLP) combined with holmium laser lithotripsy under flexible cystoscopy in the treatment of complicated nephrolithiasis. Methods The retrospective analysis was made on the clinical data of 37 patients who underwent RLP and holmium laser lithotripsy under flexible cystoscopy for complicated nephrolithiasis from January 2013 to January 2014. The clinic parameters involved basic data of patients,operational time,blood loss,post-operative hospital stay,the status of stone-free,perioperative complications,and the follow-up data of patients were observed. Results No patient was converted to open surgery. The mean stone size was (2. 8 ± 0. 9) cm in diameter,operational time was (89 ± 24) min,blood loss was (21. 3 ± 7. 7) mL,post-operative hospital stay was (6. 8 ± 1. 7) d,the stone removal rate in one session was 94. 6%. One case occurred urinary leakage,1 case occurred fever after operation,who were all recovered through conservative treatment. All cases were followed up at the sixth months after operation. Conclusion RLP combined with holmium laser lithotripsy under flexible cystoscopy is effective and safe for the treatment of com-plicated nephrolithiasis.
ABSTRACT
Though high stone free rates were reported with ESWL monotherapy or anatrophic nephrolithotomy, percutaneous nephrolithotomy with or without ESWL appears to be the procedure of choice for most staghorn calculi. A total of 41 patients with staghorn calculi underwent percutaneous nephrolithotomy(PNL) alone or primary percutaneous debulking followed by extracorporeal shock wave lithotripsy(ESWL) of residual stone fragments. For the objective analysis of the results of PNL stone removal rate was calculated with stone surface area which was determined by computer analyzer. For staghorn calculi smaller than 2000 mm2(38/41), a mean stone removal rate of about 90% was achieved in the PNL. When stone surface area exceeded 2000 mm2(3,41), the mean stone removal rate was 78.8%. The stone removal rates stratified by stone surface area were not significantly different. The stone free rate was 31.7% in the PNL only but 75.6% in the PNL with or without ESWL. The higher mean stone removal rate and stone free rate was achieved in the kidneys with non-dilated collecting system than those with hydronephrosis, but it was not statistically significant.