To analyze the effectiveness, feasibility and safety of percutaneous nephrolithotomy (PCNL) in the treatment of renal calculus with the prone split-leg position.

Three hundred and sixty patients with renal calculus were treated in our hospital from January 2016 to May 2017. One hundred and eighty nine patients in the observation group with prone split-leg position, retrograde ureteral catheterization was done and under ultrasonographic guidance 16-24 F percutaneous access tract was established. The nephroscope or ureteroscopy was introduced through the percutaneous renal channel before lithotripsy. 171 patients in the control group with traditional prone position. the first operation was retrograde intubation in lithotomy position, then changed to prone position. The next surgical method was the same as observation group. The time of establishment the channel, operation time, intraoperative blood loss, length of stay and other information were recorded. Perioperative complications were compared by means of the Clavien-Dindo classification system. S.T.O.N.E stone score, stone removal rate and reoperation rate were analyzed.

PCNL in prone split-leg position was successfully completed in all cases. The time of operation, the time of establishment for access, the amount of intraoperative blood loss, the duration of hospitalizations and the rate of reoperation were lower in the observation group than the control group(P<0.05). There was no statistical difference between the rate of stone clearance, S.T.O.N.E stone scores and blood transfusion rate (P>0.05). In Clavien-Dindo Classification System, Ⅰ, Ⅱ, Ⅲb compared between two groups had no statistical differences (P>0.05).

In the treatment of patients with renal calculus, the use of the prone split-leg PCNL is safe and feasible. In this position, the operation time, the amount of bleeding during operation and the rate of reoperation were reduced, and the safety and effectiveness of operation were improved.