Chinese minimally invasive percutaneous nephrolithotomy: the Guangzhou experience.
OBJECTIVE
Percutaneous nephrolithotomy (PCNL) using a small tract is controversial, and its indication is considered limited. In our center, however, we have performed Chinese minimally invasive PCNL regularly for managing upper-tract calculi. We report our experience.


METHODS
Our technique is not just about using smaller instruments and tracts. Our overall approach is different from the standard PCNL. We preferred a middle caliceal puncture via the 11th rib space and also relied mainly on a strong irrigant current for stone fragment removal. We reviewed and analyzed the prospectively collected database on patients who underwent minimally invasive (MPCNL) from 2001 to 2005.


RESULTS
A total of 4760 MPCNL procedures were performed in 3610 kidneys. There were 1240 staghorn stones and 85 ureteral stones. There were 14 transplanted kidneys and 27 cases of horseshoe kidneys. The average operative time was 78 minutes. The stone-free rate at postoperative day 2 was 89%. The major complication rate was 0.86%.


CONCLUSIONS
Our experience with the Chinese MPCNL shows that it is safe and effective for managing all kinds of upper-tract calculi.
Li
Xun
X
Department of Urology, The First Affiliated Hospital of Guangzhou Medical College, Guangdong, China.
He
Zhaohui
Z
Wu
Kaijun
K
Li
Shu Keung
SK
Zeng
Guohua
G
Yuan
Jian
J
He
Yongzhong
Y
Lei
Ming
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D002681:China; D004867:Equipment Design; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000601:surgery*; D007670:Kidney Calices; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation; D009403:Nephrostomy, Percutaneous / Q000295:instrumentation / Q000379:methods*; D011446:Prospective Studies; D014514:Ureteral Calculi / Q000601:surgery*; D055815:Young Adult