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| Clinical Effect of 30F Large Channel Percutaneous Nephrolithotomy with Holmium Laser Lithotripsy without Detaining Renal Fistulas for the Treatment of Staghorn Calculi |
| WANG Hai-rong, WANG Ning |
| 1st Department of Surgery, the People's Hospital of Tunchang County ,Hainan Province, Tunchang 571600 |
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Abstract 【Objective】To investigate the clinical effect of 30F large channel percutaneous nephrolithotomy with holmium laser lithotripsy without detaining renal fistulas for the treatment of staghorn calculi.【Methods】From April 2013 to November 2016, 60 patients with renal staghorn calculi were divided into observation group and control group with 30 cases in each group. The control group was treated with laparoscopic lithotripsy, the observation group was treated with 30 F large channel percutaneous nephrolithotripsy, and there was no indwelling nephrostomy tube after operation. Blood loss, operation time, hospital stay and pain score were recorded in both groups, and all patients were followed up for 1 month. Serum creatinine (SCR), glomerular filtration rate (GFR) and postoperative complications were compared between the two groups.【Results】The operative time, intraoperative bleeding volume, hospitalization days and pain score in the observation group were significantly lower than those in the control group (P<0.05). There was no significant difference in SCr,GFR between the two groups before operation (P>0.05), but the level of SCr in the observation group was significantly lower than that in the control group (P<0.05), and the level of GFR in the observation group was significantly lower than that in the control group (P<0.05). The stone clearance rate was 93.33% (28/30) in the observation group and 66.67% (20/30) in the control group. The difference was statistically significant (χ2=6.668,P=0.009<0.05) < 0.05). The total incidence of postoperative complications in the observation group was 6.67% (4/30), which was significantly lower than that in the control group (46.67%, 14 / 30). The difference was statistically significant (χ2=7.937,P=0.005<0.05).【Conclusion】30F large channel percutaneous nephrolithotomy with holmium laser lithotripsy without detaining renal fistulas for the treatment of staghorn calculi is safe and effective. It has the advantages of less trauma, high stone clearance rate and fewer complications. It has low damage to renal function and is worthy of clinical promotion and application.
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Received: 17 January 2018
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2018, Vol. 35 
