The original access percutaneous nephrolithotomy (PCNL) combined retrograde intrarenal surgery in second stage for the therapy of residual stones after PCNL

doi:10.3877/cma.j.issn.1674-3253.2024.04.0013

Abstract

Abstract:

Objective

To investigate the clinical safety and feasibility of post-PCNL residual stones treated with original access PCNL combined RIRS.

Methods

The clinical data of 22 cases with post-PCNL residual stones due to complex nephrolithiasis from September 2018 to August 2022 in Affiliated Hospital of Guangdong Medical University were analyzed retrospectively, including 13 males and 9 females, with the average age of (58±14) years. All patients were treated by the original access PCNL combined with RIRS in second stage, including 13 cases in the left and 9 cases in the right. The maximum diameter of the residual stone was (45±20) mm. The maximum cross-sectional area of the residual stone was (450±214) mm². Preoperative urine culture was positive in 10 cases.

Results

All operative procedures of PCNL combined with RIRS in 22 patients were accomplished successfully. The mean operative time was (89±25)min and the mean postoperative stay was (3.5±1.4) d. The short-term postoperative complication rate was 27.3%(6/22). Two patients had postoperative fever, which improved with anti-infection, one case required postoperative blood transfusion. The stone free rate was 77.3% (17/22) assessed by abdominal plain film or CT scan 1 to 6 days after operation. The final stone free rate was 86.4%(19/22) after adjuvant therapy.

Conclusion

PCNL combined with RIRS for treating residual stone fragments after PCNL in complex nephrolithiasis is safe and feasible, which deserves clinical application.

Key words: Nephrolithiasis, Percutaneous nephrolithotomy (PCNL), Flexible ureteroscope, Residual stone, Endoscopic combined intrarenal surgery (ECIRS)

Qizhou Mo, Jianjun Liu, Mushi Ye, Xingduan Huang, Jianwei Li, Sining Li, Jian Huang, Jin Su. The original access percutaneous nephrolithotomy (PCNL) combined retrograde intrarenal surgery in second stage for the therapy of residual stones after PCNL[J]. Chinese Journal of Endourology(Electronic Edition), 2024, 18(04): 380-385.

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URL: https://zhqjmnmwkzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-3253.2024.04.0013

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