[Results of the treatment of renal lithiasis by percutaneous nephrolithotomy: apropos of 115 cases].
OBJECTIVE
The objective of this study was to analyse the results of percutaneous nephrolithotomy (PCNL), which was recently introduced into Tunisia, in order to determine its place among the treatment options for renal stones.


METHODS
Our retrospective study was based on 115 consecutive PCNL procedures performed between April 1994 and November 1997. The stone was a single pelvic stone in 13 cases, lower caliceal in 15 cases, lower pyelocaliceal in 28 cases, partial staghorn in 20 cases, total staghorn in 16 cases and multiple pyelocaliceal in 23 cases. In our series, ultrasound lithotripsy constitutes the procedure of choice for renal stone fragmentation.


RESULTS
A good result was obtained immediately in 67% of cases. This figure is lower than that published in the literature because of the complexity of the stones and the high failure rate due to the learning curve, involving 6 members of the team. In the case of failure, the procedure was converted to conventional surgery under the same anaesthetic in 20 patients. Residual stones, observed in 23 patients, were successfully treated by extracorporeal shock-wave lithotripsy (ESWL) in 79% of cases. By combining PCNL and ESWL, the good result rate was 80%. The mortality rate of this series was 0.8% and the morbidity rate was 7.5%. Complications were generally rare and often minor.


CONCLUSIONS
PCNL occupies an important place in the treatment of renal stones. The results depend on the site, size and number of stones and on the operator's experience.
Jemni
M
M
Service d'Urologie, Hôpital Charles Nicolle, Tunis, Tunisie.
Bacha
K
K
Ben Hassine
L
L
Karray
M S
MS
Ayed
M
M
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000601:surgery* / Q000628:therapy*; D008096:Lithotripsy; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000379:methods; D012189:Retrospective Studies; D012737:Sex Factors