Li Hu-lin, Liu Chun-xiao, Xu A-bai, Xu Kai, Chen Bin-shen, Guo Kai, Lin Yang-yan, Zhu Rui-long
Department of Urology, Southern Medical University, Guangzhou, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2011 Dec;31(12):2079-81.
To discuss the optimal approach of percutaneous nephrolithotomy (PCNL) for treatment of complicated renal calculi.
A total of 581 patients with complicated renal calculus were treated by PCNL through the upper pole calix access. Of the 581 patients, 55 had multiple upper pole calculi, 136 had staghorn stones, 145 had partial staghorn stones, and 245 had multiple renal calculi.
PCNL through the upper pole calix access was completed successfully in all the cases. Of these patients, 90.3% (525/581) were stone-free after a single access, with a total stone-free rate of 94.6% (550/581). Thirty-five patients needed two accesses, 10 needed 3 accesses, 2 required 4 accesses, and 1 patients had 5 accesses. The operative time ranged from 30 to 150 min (mean 45 min). The successful rate of puncture was 100% without occurrence of severe injury of the pleura, intestine, peritoneum or other adjacent organs.
Percutaneous nephrolithotomy through the upper pole calix access allows greater stone clearance rate due to its easy access into the intrarenal collecting system and can be an ideal approach for PCNL for complicated renal calculi.
探讨经皮肾镜取石术（PCNL）治疗复杂性肾结石的最佳途径。
581例复杂性肾结石患者采用经上盏入路行PCNL治疗。581例患者中，55例为多发性上盏结石，136例为鹿角形结石，145例为部分鹿角形结石，245例为多发性肾结石。
所有病例均成功完成经上盏入路PCNL。其中，单次穿刺取石术后结石清除率为90.3%（525/581），总结石清除率为94.6%（550/581）。35例患者需要二次穿刺，10例需要三次穿刺，2例需要四次穿刺，1例需要五次穿刺。手术时间为30～150分钟（平均45分钟）。穿刺成功率为100%，未发生胸膜、肠管、腹膜或其他邻近器官的严重损伤。
经上盏入路的经皮肾镜取石术因其易于进入肾内集合系统，结石清除率更高，可作为治疗复杂性肾结石的理想PCNL途径。
