A Combined Pneumatic And Ultrasound Lithotripsy During Percutaneous Nephrolithotomy Under B Ultrasound Guidance For Treatment Of Renal And Upper Ureteral Calculi (Report Of 50 Cases)

Objective To investigate the clinical efficacy of combined pneumatic and ultrasoud lithotripsy for treatmentment of renal and upper ureteral calculi during percutaneous nephrolithotomy under ultrasound guidance.Methods Fifty patients(31 males,29 females) were treated with PCNL from Jan 2008 to Oct 2008.The mean stone diameter was 3.2(1.2-5.5)cm.The kidney was Punctured under ultrasonography guidance.The working channel was dilated until an F24 metal sheath was positioned.Under F20.8 nephroscopy,ultrasonic,pneumatie probes or combined were used for lithotripsy.Results All the cases were cured successfully in one stage.The mean operative time was 45 min(range 10-180 min).The average blood loss was 60 ml(range 20-400 ml).One cases had severe hemorrhage postoperatively.No severe infection was observed.The calculi degradation rate was 100%,and the calculi clearance rate was 90%(45/50) while 2 cases had a residual calculi smaller than 0.8 cm due to an inaccessible location.These 2 cases were cured by ESWL.No severe complications occurred during nephrolithotomy after follow-up of 1 to 8 months.Conclusion PCNL under ultrasound guidance for treatment of upper urinary tract calculi can obtain a accurate locating,and the construction of tunnel is safe and convenient.Without X ray damage human body.A combined pneumatic and ultrasound lithotripsy device deal with complex upper urinary tract calculi during percutaneous nephrolithotomy appears to be efficacious and safe for calculi clearance with quick recovery period and less complication.