PCNL Standard Tract Supporting A Micro-tract Is Safe And Efective In Treating Renal Staghorn Calculi

Objective: By comparing the operation time and stone clearance rate of percutaneous nephrolithotomy with three methods of the single standard channel, dual micro-channel and standard channel with a micro-channel in treatment of staghorn renal stone, we plan to evaluate the efficiency of percutaneous nephrolithotomy with standard channel with a micro-channel. By detecting the change of postoperative hemodynamics, blood biochemical and CRP (C reactive protein) in the body, we plan to evaluate the safety of percutaneous nephrolithotomy and provide theoretical evidence for clinical treatment.Methods: 115 cases meeting the inclusion criteria of the research were involved in the study.They all underwent percutaneous nephrolithotomy and were divided into three groups of the standard channel with a micro-channel, dual micro- channel and single standard channel.We compared the difference of operation time and stone clearance rate and CRP among the three groups. Electrolyte balance and system hemodynamics were detected in the group of standard channel with a micro-channel.Results: The group of standard channel with a micro-channel were significantly different comparing with the other two groups, with shorter operative time, and higher stone clearance rate( P <0.05). Electrolyte balance, blood gas analysis and renal function did not change significantly before surgery, 60 minutes of surgery , the end of surgery and 24 hours after surgery(P> 0.05).Systolic blood pressure,diastolic blood pressure and central venous pressure did not change significantly(P>0.05). Perioperative CRP did not change significantly between the other groups(P> 0.05).Conclusions: 1. Percutaneous nephrolithotomy has some blind spots and the single channel method has difficulty in clearing all the stones.Muitiple channels are needed in certain cases. Micro-channel has the advantage of minimal trauma but with narrow field of vision. Muiti-channel in treating with large staghorn renal stone has the disadvantage of low efficiency.Standard channel with a micro-channel can overcome the shortcomings.2. The standard channel with a micro-channel has obvious advantages in reducing operation time and improving stone clearance rate compared to the single and double micro-channel. 3. The standard channel with a micro-channel on patients with normal organ are unlikely to cause dramatic changes in blood circulation.Using saline as the perfusion fluid will not cause changes in blood biochemistry and will not increase injury. Percutaneous nephrolithotomy in the standard channel with a micro-channel application is safe in the treatment of staghorn renal calculi.