Abstract：Objective： To evaluate the safety and efficacy of a dual negative pressure system（DNPS） which consists of a negative pressure sheath and a ultrasonic lithotripsy device in percutaneous nephrolithotomy（PCNL）. Methods： A total of 138 patients received PCNL with the DNPS from August 2018 to September 2021. The clinical data including operating time, stone free rate（SFR）, hemoglobin decrease, creatinine change, postoperative hospital stay, fever, bleeding, and urosepsis were recorded. Results： All procedures were performed successfully. Mean stone diameter was 3.6 cm（2.0-6.4 cm）. Mean operating time was 35 min（10-63 min）.mean postoperative hospital stay was 5.9d（5-14 d）.The four-day postoperative SFR was 92.0%（127/138）.Postoperative fever occurred in 8 patients（5.8%）. No urosepsis or severe intraoperative hemorrhage occurred. Bleeding occurred in 2 patients after removing of the nephrostomy tube, which were both cured by embolization of the corresponding renal artery branches. Conclusion： The application of DNPS in PCNL can improve efficiency of stone clearance, maintain low renal pelvic pressure during operation, reduce the chance of postoperative infection, and is cost-effective. The DNPS deserves further clinical application.
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