Abstract：Objective:To compare the safety and efficiency of the F20 Peel-away plastic sheath and F24 standard metal sheath used in percutaneous nephrolithotomy. Methods:A total of 66 patients who underwent PCNL for renal or ureteral calculi were enrolled, including 42 with the Wolf F24 standard metal sheath and 24 with the F20 percutaneous renal sheath made by COOK company. Target renal calices were chosen and punctured under ultrasound guidance. Accesses were expanded with dilators and percutaneous renal accesses were established with Wolf F24 standard metal sheath or F20 plastic sheath. A Wolf F20.8 standard nephroscope was put in and Cyberwand double catheter lithotripsy system or EMS pneumatic lithotripsy was used to break stones. Details of every operation such as phase I stone-free rate, operative time and complications were recorded and analysed. Results:Percutaneous renal accesses were successfully established in all patients. The phase I stone-free rate of the two groups were 88.1%(37/42) and 87.5%(21/24) respectively (P＞0.05). The mean operative time were (78.6±12.5)min and (73.4±9.2)min respectively (P＞0.05). There were 6 and 3 cases with post-operative fever respectively(P＞0.05). No blood transfusion cases occurred. Conclusions:There are no significant differences in phase I stone-free rate, operative time and complications between the F20 Peel-away plastic sheath and F24 standard metal sheath. The F20.8 standard nephroscope can be put in F20 plastic sheath successfully. As a new method for percutaneous nephrolithotomy, the F20 plastic sheath allows removal of bigger stones and provides an access that is not easily lost and less likely to harm the kidney.
[1]Tefekli A, Cordeiro E, de la Rosette JJ. An update on percutaneous nephrolithotomy: lessons learned from the CROES PCNL Global Study. Minerva Med, 2013,104(1):1-21. [2]el-Nahas AR, Eraky I, Shokeir AA, et al.Factors affecting stone-free rate and complications of percutaneous nephrolithotomy for treatment of staghorn stone.Urology, 2012,79(6):1236-1241. [3]李逊,曾国华,袁坚,等. 经皮肾穿刺取石术治疗上尿路结石(20年经验). 北京大学学报(医学版), 2004,36(2):124-126. [4]胡卫国,李建兴,杨波,等. 标准通道经皮肾镜碎石术前预测方案与术中手术方案差异的分析.中华泌尿外科杂志, 2013,34(1):17-19. [5]张树栋,肖春雷,马潞林,等. 肾上盏入路经皮肾镜取石术的疗效与安全性探讨.中华泌尿外科杂志, 2011,32(1): 20-23. [6]Akman T, Binbay M, Kezer C, et al.Factors affecting kidney function and stone recurrence rate after percutaneous nephrolithotomy for staghorn calculi: outcomes of a long-term followup. J Urol, 2012,187(5):1656-1661. [7]Mishra S, Ganesamoni R, Ganpule AP, et al. Supine percutaneous nephrolithotomy for bilateral complete staghorn calculi in an L-shaped cross-fused renal ectopic anomaly. Urology, 2013,81(1): e3-4. [8]Maghsoudi R, Etemadian M, Shadpour P, et al.Number of tracts or stone size: which influences outcome of percutaneous nephrolithotomy for staghorn renal stones? Urol Int, 2012, 89(1): 103- 106.
