Minimally invasive percutaneous nephrolithotomy with different pathways in treatment of upper calyx calculi (report of 64 cases)

    Yuan Jian, Lei Ming, Wang Luping, Liu Guanzhao, Luo Jintai, Liu Yongda, Ye Zheng

    (Department of Urology, Minimally Invasive Surgery Center, the First Affiliated Hospital of Guangzhou Medical College, Guangzhou 510230, China)

    ABSTRACT: Objective To summarize experience and improve the level of treating upper calyx calculi with minimally invasive percutaneous nephrolithotomy (MPCNL). Methods 64 patients underwent minimally invasive percutaneous nephrolithotomy. The operative approach, effect and main complications were summarized retrospectivelly. Results 43 patients underwent middle calyx nephrostome,the stoneª²free rate being 88.4%; 7 patients lower calyx nephrostome,the stoneª²free rate being 85.7%; 14 patients upper calyx nephrostome, the stoneª²free rate being 78.6%;1 patient with 10th subocostal and upper calyx nephrostomy, suffered from light hydrothorax after the nephrostomy tube was pulled out on 6th day postoperation. None of the patients suffered from severe haemorrhage or needed transfusion. Conclusion Chosing appropriate pathway of MPCNL according to the size, shape, site of the upper calyx calculi and the anatomy construction of kidney collecting system, can improve the efficacy and decrease complications. ......