Relationship Between Percutaneous Nephrolithotomy Treatment Of Complex Renal Calculi Efficacy And Channel Selection

Objective: To further explore the best treatment options forcomplex renal calculi, this study by comparing different channel selection inpercutaneous nephrolithotomy safety and therapeutic effect of treatment ofcomplex renal calculi, choose to provide a theoretical basis for the clinicaltreatment of complex renal calculi program. Methods: Of Luzhou MedicalCollege Affiliated First People’s Hospital of Yibin City of Urology duringdetailed examination of patients with kidney stones were treated by theinclusion and exclusion criteria of the design, and signed informed consent，since July2011, the cases ultimately selected timenumbered in the order inorder by number classified as standard channel group, microchannel group anddual micro-channel group. All patients choose to use three kinds of channelpercutaneous nephrolithotomy surgery, Experiment until July2012, the finalcases of126cases, each group the number of cases to42cases., The patients instandard channel group (47.9±12.6) years old; microchannel group (50.3±13.6) years old; dual microchannel group (48.2±14.4) years old. Stone size:standard channel group (4.16±1.18) cm; microchannel group (4.45±1.26) cm;dual microchannel group (4.29±1.26) cm. All patients underwent colorDoppler guided PCNL, the three groups of patients with operative time, stoneclearance rate, postoperative hospital stay were compared, comparison of the therapeutic effect of the differences in each group; The three groups of patientswith preoperative and postoperative complication rate, blood loss werecompared, comparison of the security of the differences in each group. Results:126patients were successfully operated, the complication rate is the standardchannel group was14.29%, microchannel group was9.52%, dualmicro-channel group was9.52%. Micro channel group and dual micro-channelgroup have the same complication rates, these two groups compared with thestandard channel group, by χ2tested (χ2=0.454, P=0.736), the difference wasnot statistically significant (P>0.05). Postoperative stone clearance rate：standard channel group69.05%, microchannel group66.67%, dualmicro-channel group88.10%. Standard channel group with micro-channelgroup stone clearance rate, by χ2test (χ2=0.055, P=0.815), the differencewas not statistically significant (P>0.05); standard dual channel group andbetween groups microchannel stone clearance rate by χ2test (χ2=4.525, P=0.033), the difference was statistically significant (P <0.05); comparisonbetween stone clearance rate and dual microchannel group microchannel group,the χ2test (χ2=5.509, P=0.019), the difference was statistically significant(P <0.05). For the stones long diameter greater than or equal to5cm of cases,the standard channel group stone clearance rate was33.33%, micro-channelgroup stone clearance rate was30.77%, dual microchannel group stoneclearance rate was75%. Standard channel group with micro-channel groupstone clearance rate, by χ2test (χ2=0.012, P=0.851), the difference was not statistically significant (P>0.05). Standard channel group and dualmicro-channel group stone clearance rate, by χ2test (χ2=5.239, P=0.022), thedifference was statistically significant (P <0.05). Micro-channel groupcompared with the dual micro-channel group between stone clearance rate, byχ2test (χ2=3.576, P=0.027), the difference was statistically significant (P <0.05). Operation time: standard channel group (67.98±27.61) minutes;micro-channel group (69.76±24.79) minutes; dual micro-channel group (61.79±21.21) minutes. These three groups of patients after surgical time be paired ttest, the difference was not statistically significant (P>0.05). Blood losscomparison: standard channel group (70.71±40.18)ml; micro-channel group(78.71±36.51)ml; dual micro-channel group (79.69±40.84)ml. Three groupsof patients with blood loss between two paired t-test, the difference was notstatistically significant (P>0.05). Postoperative hospital stay: Standard channelgroup (8.45±2.66) days; micro-channel group (8.33±3.06) days; dualmicro-channel group (8.00±1.93) days, three groups of patients afterhospitalization time pairwise paired t-test, the difference was not statisticallysignificant (P>0.05). Conclusion: Standard channel, micro-channel, dualmicrochannel PCNL treatment of complex renal calculi was no significantdifference in operative time, blood loss, hospital stay and postoperativecomplication rates which several indicators. A single channel PCNL treatmentof complicated renal calculi higher rate of postoperative residual stone thandual microchannel, often require two operations. Dual microchannel treatment of complex renal calculi can significantly improve stone clearance rate, bloodloss and postoperative complications did not increase, it could be as thepreferred treatment of complex renal calculi, especially stones larger than orequal to5cm full mold stones.