A retrospective comparative study of minimally invasive percutaneous nephrolithotomy in the treatment of simple and complex renal caliceal stones
Yang Bicheng1, Zhao Zhijian1, Zhong Wen1, Mai Zanlin1, Wu Wenqi1, Yuan Jian1, Zeng Guohua1
1Department of Urology,Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, and Guangdong Key Laboratory of Urology, Guangzhou, 510000,China
Abstract：Objective:To compare the safety and effectiveness of MPCNL in the treatment of simple and complex renal caliceal stones. Methods:5 761(41.2%) simple caliceal stones and 8 223 (58.8%) complex caliceal stones managed by MPCNL were retrospectively investigated. Results:Larger stone burden was observed in complex stones (1 763.0∶1 018.6 mm2, P＜0.05). Shorter operative time (72.4-28.4∶90.4-41.9, P＜0.001), less multiple percutaneous accesses (1.9%∶20.7%, P＜0.001), and less change in hemoglobin levels (12.3±10.7∶14.4±11.6 g/L, P＜0.001) were gained in patients bearing simple stones. Though complex stones had a lower stone-free rate for the initial session of MPCNL (77.6%∶66.4%, P＜0.05), no significant difference was found after secondary procedure (81.3%∶80.1%, P＞0.05). The complication rate (25.17%∶26.32%, P＞0.05) and blood transfusion rate (2.2%∶3.2%, P＞0.05) showed no significant difference in both groups. But the renal vascular embolizaitons appeared to be higher in complex stones (0.28%∶0.67%, P＜0.05). Conclusions:MPCNL serves as a reasonable option for complex caliceal stone patients with its safety and effectiveness. The lower initial stone free rate in patients with complex caliceal stones diminished with secondary procedures.
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