Abstract：Objective: To explore the efficacy of the technique by combining mini-invasive percutaneous nephrolithotomy (mPCNL) with retrograde intrarenal surgery (RIRS) in a second stage to treat the complex renal stones in horseshoe kidney. Methods: mPCNL with a single F16-F18 tract was performed first and RIRS was carried out at a second stage in solitary kidneys of 16 patients. The clinical data and curative effect indexes were evaluated. Results: No significant difference was found in age, sex, stone location, stone size of the 16 cases (P>0.05). Of the 16 mPCNL cases, mean operative of mPCNL was (70±31) min, the average blood loss was (420±240) mL, and the incidence of complications was 6.3% (1/16). At 7th day after mPCNL, 11 cases had residual stones with a mean size of 1.6 (0.8-2.0) cm. The mean operative time of RIRS was (62±21) min, and stone-free rate after RIRS was 87.5% (14/16). Two cases accepted ESWL. At the 3rd to 12th month during the follow-up period, renal function became stable or improved. Conclusions: mPCNL combined with RIRS could be an effective and safe option for complex stones in horseshoe kidney with less bleeding, minor complications and better renal function preservation.
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