CT-guided Percutaneous Nephrostomy Combined With Secondary Percutaneous Nephrolithotomy For Infectious Staghorn Calculi

Objective:To evaluate the feasibility, efficacy and safety of treatment for infectious staghorn calculi through CT-guided percutaneous nephrostomy combined with secondary percutaneous nephrolithotomy.Methods:30patients with infectious staghorn calculifrom January2011to December2013in SIR RUN RUN SHAW hospital were retrospectively analyzed. All patients underwent preoperative BUS、KUB+IVP、CT、routine urine test midstream urine culture to diagnose infectious staghorn calculi.12patients were underwent CT-guided percutaneous nephrostomy combined with secondary percutaneous nephrolithotomy.18patients were underwent percutaneous nephrolithotomy. The operative time, amount of bleeding, stone clearance rate and time of discharge after operation, cost and occurs of complications were evaluated.Results:The two groups had no significant difference in Sex、Hydronephrosis、 S.T.O.N.E. Nephrolithometry scores(P>0.05) but in Age(P<0.05). The age of CT group and B ultrasonic group were respectively (61.2±11.7) years and (52.0±11.8) years. The operative time of CT group and B ultrasonic group were respectively (118±15.7)min and(151.9±35.3)min, amount of bleeding were(37.1±17.9)ml and (68.9±43.3) ml, cost were (31.4±3.8) thousand yuan and (28.3±3.6) thousand yuan, Time of discharge after operation were(4.5±1.2)d and(5.6±1.2)d, stone clearance rate after first operation were were91.7%(11/12) and83.3%(15/18), occurs of complications were16.7%(2/12) and33.3%(6/18). they all had a significant difference(P<0.05).Conclusion:Compared with percutaneous nephrolithotomy, CT-guided percutaneous nephrostomy combined with secondary percutaneous nephrolithotomy has an advantage in operative time, blood loss, time of discharge after operation, occurs of complications and stone clearance rate after first operation. But it has a higher cost than percutaneous nephrolithotomy.