A comparison of two pathways of percutaneous nephrolithotomy in the treatment of complex lower calyceal calculi

HUANG Suxi; YANG Renming; CHAI Yinghao; HAI Lati; ZHANG Benlin

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Medical Journal of the Chinese People Armed Police Forces ›› 2021, Vol. 32 ›› Issue (10) : 868-871.

ORIGINAL ARTICLES

A comparison of two pathways of percutaneous nephrolithotomy in the treatment of complex lower calyceal calculi

HUANG Suxi¹, YANG Renming¹, CHAI Yinghao², HAI Lati¹, ZHANG Benlin¹

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Abstract

Objective To compare the efficacy of two pathways of percutaneous nephrolithotomy (PCNL) in the treatment of complex lower calyceal calculi. Methods The clinical data on 258 cases of complicated lower calyceal calculi treated with PCNL between October 2015 and October 2020 in the Department of Urology at our hospital was retrospectively analyzed. According to the puncture pathway, the patients were divided into the upper calyx group and lower calyx group. The difference in efficacy between the two pathways of PCNL was studied in terms of duration of surgery,complete stone clearance rates and intraoperative and postoperative complications. Results All the patients had their access established in phase I. The stone clearance rate of upper calyces (85.92%) was significantly higher than that of lower calyces (59.62%). The duration of surgery was (74.69±2.94) min in the upper calyx group and (84.50±15.25) min in the lower calyx group. The incidence of postoperative complications was 6.31% in the upper calyx group and 32.69% in the lower calyx group. The decrease of hemoglobin was (13.10±0.60) g/L in the upper calyx group and (14.60±0.30) g/L in the lower calyx group.The difference was statistically significant (P<0.05). The incidence of bleeding and infections in the upper calyx group was significantly lower than in the lower calyces. Conclusions PCNL for complex lower calyceal calculi via the upper calyceal pathway is safe and effective with a high stone clearance rate, less bleeding and shorter duration of surgery.

Key words

percutaneous nephrolithotomy / lower calyx / upper calyx / kindey stones

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HUANG Suxi, YANG Renming, CHAI Yinghao, HAI Lati, ZHANG Benlin. A comparison of two pathways of percutaneous nephrolithotomy in the treatment of complex lower calyceal calculi[J]. Medical Journal of the Chinese People Armed Police Forces. 2021, 32(10): 868-871

References

[1] 闫泽晨,徐鹏超,田雨冬,等.输尿管软镜下钬激光联合套石篮治疗肾下盏结石的效果[J].河南医学研究,2019,28(12):2165-2166.
[2] Yang Bowei,Li Jiongming,Liu Jianhe,et al.Safe surgical treatment of peripelvic renal cyst combined with renal calculi by percutaneous nephroscopy[J].Clin Case Reports,2018,6(2):635-636.
[3] Aron M,Goel R,Kesarwani P K,et al.Upper pole access for complex lower pole renal calculi[J] BJU,2004,194(6):849-852.
[4] 张涛,刘学进,熊建荣,等.两种微创术式对>2 cm肾下盏结石患者结石清除效果? 围手术期临床指标及并发症的影响[J].临床泌尿外科杂志,2017,32(10):793-796.
[5] 梁福律,涂建平,林剑峰,等.超微经皮肾镜与电子输尿管软镜治疗肾中上盏2.0-2.5 cm结石疗效的比较[J].临床泌尿外科杂志,2019,34(12):965-968.
[6] 叶利洪,李雨林,李王坚,等.肾下盏解剖结构对输尿管软镜下钬激光碎石治疗肾下盏结石疗效的影响[J].中华泌尿外科杂志,2013,34(1):24-27.
[7] Geavlete P,Multescu R,Geavlete B.Influence of pyelocaliceal anatomy on the success of flexible ureteroscopic approach[J].J Endoyrol,2008,22(10):2235-2239.
[8] 李炯明.肾下盏结石的治疗首选经皮肾镜取石术[J].现代泌尿外科杂志, 2014,19 (4):269-270.
[9] 孙毅海,宋平义,王晓平,等.肾下盏解剖对结石排出的影响[J].现代泌尿外科杂志,2003,8(2):71-72.
[10] Sampaio F J,Aragao A H. Anatomical relationship between the intrarenal arteries and the kidney collecting system[J].J Urol,1990,143(4):679-681.
[11] 刘永达,钟惟德,袁坚,等.肾上盏入路经皮肾镜取石术的安全性及效果分析[J].中华泌尿外科杂志,2012,33(6):409-412.
[12] 张雪培,可方,王声政,等.经皮肾镜碎石术术中及术后出血风险因素分析[J].现代泌尿外科杂志,2016,21(2):108-111.
[13] 余伟民,曹君,阮远,等.超声引导“经肾盏穹窿盏颈轴线两步穿刺法”建立经皮肾通道[J/CD].中华腔镜泌尿外科杂志:电子版,2016,10(3):148-152.
[14] Kim S C, Ng J C, Matlaga B R, et al.Use of lower pole nephrostomy drainage following endorenal surgery through an upper pole access [J].J Urol,2006,175(2):580-584.
[15] 马潞林.新曼泌尿外科手术图解[M].3 版.北京:北京大学出版社,2013:766-774.
[16] 李小航,朱玮,李九智,等.不同肾盏穿刺微创经皮肾镜取石术治疗复杂性肾结石的疗效比较[J].临床泌尿外科杂志,2017,32(6):413-417.
[17] 武立新,吴刚,王贺彬,等.经上盏与经中盏入路PNL术治疗肾结石合并输尿管结石效果比较[J].山东医药,2013,53(42):50-52.
[18] Maghsoudi R, Etemadian M, Kash A H, et al.Management of colon perforation during percutaneous nephrolithotomy:12 years of experience in a referral center [J].J Endourol,2017,31(10):1032-1036.
[19] Öztürk H.Gastrointestinal system complications in percutaneous nephrolithotomy:a systematic review [J].J Endourol,2014,28(11):1256 -1267.