title: A novel minimally invasive percutaneous nephrolithotomy technique: safety and efficacy report.
abstract: OBJECTIVE
  The aim of this study was to evaluate the outcome and determine the complications of ultrasound-guided 16 F tract percutaneous nephrolithotomy (PCNL) by review of over 1000 cases in a Chinese hospital.
  
  
  METHODS
  A total of 1368 patients underwent 16 F tract PCNL in the hospital between March 2007 and July 2013. Surgery was performed under general anesthesia in all cases. Central venous puncture was chosen as a puncture device. Complications, residual stones, stone clearance and the need for auxiliary treatments were evaluated. Management experience was evaluated with respect to the complications.
  
  
  RESULTS
  Complications occurred in 275 out of 1368 patients (20.1%). There were 102 Clavien grade 1 (7.4%), 121 grade 2 (8.8%) and 48 grade 3 (3.5%) complications, but no grade 4 or 5 complications. Access to the kidney was established in 99.7% of cases and 82.0% of cases had complete stone clearance without undergoing further PCNL. Auxiliary treatments included shockwave lithotripsy in 135 patients, second-phase PCNL in 49 patients and ureteroscopy in 63 patients. Three cases of rare complications occurred, including a double-J stent translocated to the chest, and intraoperative acute pulmonary edema and heart failure. Severe intraoperative or postoperative complications should be managed immediately.
  
  
  CONCLUSIONS
  An ultrasound-guided mini-tract PCNL is safe and convenient, even for patients with complicated stones.
authors.affiliation: Urology Department, Tenth People's Hospital of Tongji University , Shanghai , PR China.
authors.forename: Guanghui
authors.initials: G
authors.lastname: Hu
authors.forename: Zhuifeng
authors.initials: Z
authors.lastname: Guo
authors.forename: Huan
authors.initials: H
authors.lastname: Liu
authors.forename: Ming
authors.initials: M
authors.lastname: Luo
authors.forename: Min
authors.initials: M
authors.lastname: Liu
authors.forename: Peng
authors.initials: P
authors.lastname: Lai
authors.forename: Haimin
authors.initials: H
authors.lastname: Zhang
authors.forename: Jing
authors.initials: J
authors.lastname: Yuan
authors.forename: Xudong
authors.initials: X
authors.lastname: Yao
authors.forename: Junhua
authors.initials: J
authors.lastname: Zheng
authors.forename: Yunfei
authors.initials: Y
authors.lastname: Xu
mesh_terms: D002681:China; D005260:Female; D006333:Heart Failure / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007669:Kidney Calculi / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects* / Q000379:methods*; D009403:Nephrostomy, Percutaneous / Q000009:adverse effects* / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology; D011654:Pulmonary Edema / Q000453:epidemiology; D012189:Retrospective Studies; D016896:Treatment Outcome; D014463:Ultrasonography
keywords: complications; efficacy; management; mini-percutaneous nephrolithotomy; safety