Effect observation of minimal invasive percutaneous nephroscopy combined with electronic flexible ureteroscopy holmium laser lithotripsy in the treatment of staghorn renal calculus
PAN Wei-bing ZHANG Sui-bing▲ XIE Li-ren
Department of Urology,Pepole′s Hospital of Pingshan New District in Shenzhen City of Guangdong Province,Shenzhen 518118,China
Abstract:Objective To investigate the safety and efficacy of percutaneous nephroscopycombined with electronic flexible ureteroscopy holmium laser lithotripsy in the treatment of staghorn renal calculus.Methods 60 patients with staghorn renal calculus treated by our hospital from January 2013 to April 2016 were retrospectively analyzed.They were divided into treatment group(n=20)and control groupn(n=40).The treatment group was given percutaneous nephroscopy combined with electronic flexible ureteroscopy holmium laser lithotripsy treatment,while control group was given percutaneous nephroscopy holmium laser lithotripsy treatment.The curative effect of operation between two groups was compared.Results Clearance rate of stageⅠcalculus and comprehensive stone in treatment group was significantly higher than that of control group respectively(80.0%vs 50.0%,90.0%vs 67.5%);the average amount of bleeding during operation was significantly less than that of control group[(9.1±1.6)ml vs(22.1±7.6)ml](P<0.05).Conclusion Minimal invasive percutaneous nephroscopy combined with electronic flexible ureteroscopy holmium laser lithotripsy in the treatment of staghorn renal calculus is a safe and effective operation,and it can improve the clearance rate of calculus and reduce blood loss.
de la Rosette J,Assimos D,Desai M,et al.The clinical research office of the endourological society percutaneous nephrolithotomy global study:indicationgs,complications,and outcomes in 5803 patients[J].J Endourol,2011,25(1):11-17.
Bhaskar KS,Omar A,Aneesh S,et al.Flexibie ureterorenoscopy:tips and tricks[J].J Urol Ann,2013,5(1):1-6.
[3]
Desai M,De Lisa A,Turnal B,et al.The clinical research office of the endourological society percutaneous nephrolithotomy global study:staghorn versus non staghorn stones[J].J Endourol,2011,25(8):1263-1268.
[4]
Akman T,Sari E,Binbay M,et al.Comparison of outcomes after percutaneous nephrolithotomy of staghorn calculi in those with single and multiple accesses[J].J Endourol,2010,24(6):955-960.
[5]
Singla M,Srivastava A,Kapoor R,et al.Aggressive approach to staghorn calculi safety and efficacy of multiple tracts percutaneous nephrolithotomy[J].Urology,2008,71(6):1039-1042.
[6]
Takazawa R,Kitayama S,Tsujii T,et al.Successful outcome of flexible ureteroscopy with holmium laser lithotripsy for renal stones 2 cm or greater[J].Int J Urol,2012,19(3):264-267.
Agrawal MS,Singh SK,Singh H.Management of multiple/ staghorn kidney stones:open surgery versus PCNL(with or without EWSL)[J].Indian J Urol,2009,25(2):284-285.
[9]
Yili L,Yongzhi L,Ning L,et al.Flexible ureteroscopy and holmium laser lithotripsy for treatment of upper urinary tract calculi in patients with autosomal dominant polycystic kidney disease[J].Urol Res,2012,40(1):87-97.
Cecen K,Karadag MA,Demir A,et al.Flexibie ureterorenoscopy versus extracorporeal shock wave lithotripsy for the treatment of upper/middle calyx kidney stones of 10-20 mm:a retrospective analysis of 1 74 patients[J].Springerplus,2014,3(1):1-5.
[25]
Chen S,Zhu L,Yang S,et al.High-vs low-power holmium laser lithotripsy:a prospective,randomized study in patients undergoing multitract minipercutaneous nephrolithotomy[J].Urology,2012,79(2):293-297.