Safety And Efficacy Of PCNL In Flank Position For Management Of Complicated Kidney Stones:Results In38Patients

OBJECTIVE:To evaluate the safety and efficacy of percutaneous nephrolithotomy in flank position, with the experence of minimally invasive urology center of Shandong Provincial Hospital。METHODS:From October2007to August2012,,a total number of38candidates for PCNL were underwent ultrasonography-guided PCNL for complicated kidney stones in lateral position at our center.Complicated kidney stones include horseshoe kidney stones、 solitary kidney stones、staghorn calculus. A standard ultrosonography-guided PCNL was performed in the flank position using adult nephroscopes. Stone clearance was assessed on KUB plain film in all patients at1st month after surgery and an ultrasound or CT scan in selected cases.RESULTS:12of these patients had staghorn calculi. One patient had a horseshoe kidney. Three patients had a solitary kidney. In20patients, the primary tract was placed into the superior calyx and4of these were above the12th rib. A21Fr nephroscope was used through a24Fr tract in all patients. All patients were managed through a single tract.35patients had complete clearance while3patients each required ESWL and ureteroscopy for residual fragments.. One patient required intravenous antibiotics for post-operative fever while another4developedpost-operative bleeding that was gaven transfusion and managed conservatively The success rates were92%in flank position. The mean access duration was6.9±4.2min, and the mean operation time was98.7±37.4min None of the patients had pyelocaliceal perforation.The mean postoperative hspital days was7.2±2.3. All patients return to remove the ureteral stent in1-3month.CONCLUSION:1.We believe that PCNL in flank position is an effective methods to deal with complicated kidney stones with a high success rates.2.PCNL in flank position is a realatively safe methods with a quite low complication rate.3.PCNL was the method of choice when dealing with complex renal kidney stones (including staghorn calculi,horseshoe kidney calculi, solitary kidney calculi)...