title: Types of Renal Calculi and Management Regimen for Chinese Minimally Invasive Percutaneous Nephrolithotomy.
abstract: Strict selection of patients for minimally invasive percutaneous nephrolithotomy could effectively improve the success rate of surgery. This study aimed to understand the required skills and the efficacy of mini-PCNL in the treatment of five types of upper ureteral calculi. Data collected after X-ray analysis and B mode ultrasound from 633 patients with upper ureteral and renal pelvis calculi who underwent B ultrasound-guided lithotomy was reviewed, including the following: type I, upper ureteral or renal pelvis calculi with moderate hydronephrosis (154 cases); type II, upper ureteral or renal pelvis calculi with severe hydronephrosis (157 cases); type III, upper ureteral or renal pelvis calculi without hydronephrosis (61 cases); type IV, renal pelvis calculi, one or two renal calyx calculi (206 cases); and type V, renal staghorn calculi (55 cases). Operations on 611 cases were successful. The treatment method for five patients was converted to open surgery. Twelve cases were treated by indwelling double-J tube retro-catheterization and extracorporeal shock wave lithotripsy. Five patients gave up the treatment. The rate of calculus clearance was 82.3 %, and the rate of residual calculus was 17.6 %. Selective renal artery embolization was performed in nine cases. Hydropneumothorax occurred in nine cases. No intestinal fistula occurred, and no patient had to undergo nephrectomy. The difficulty and the curative effect of the operation were different because the types of calculi varied. Selection of the procedure based on the different types of calculi could effectively improve the success rate of the procedure, reduce complications, and shorten the learning curve.
authors.affiliation: Department of Urology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No. 1665 Kongjiang Road Yangpu District, 200092 Shanghai, China.
authors.forename: Si-Ping
authors.initials: SP
authors.lastname: Gu
authors.affiliation: Department of Minimally Invasive Surgery, Shishi Hospital, 362700 Shishi, Fujian Province China.
authors.forename: Guo-Hua
authors.initials: GH
authors.lastname: Zeng
authors.affiliation: Department of Urology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No. 1665 Kongjiang Road Yangpu District, 200092 Shanghai, China.
authors.forename: Zhi-Yuan
authors.initials: ZY
authors.lastname: You
authors.affiliation: Department of Minimally Invasive Surgery, Shishi Hospital, 362700 Shishi, Fujian Province China.
authors.forename: Yi-Jin
authors.initials: YJ
authors.lastname: Lu
authors.affiliation: Department of Minimally Invasive Surgery, Shishi Hospital, 362700 Shishi, Fujian Province China.
authors.forename: Yun-Teng
authors.initials: YT
authors.lastname: Huang
authors.affiliation: Department of Urology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No. 1665 Kongjiang Road Yangpu District, 200092 Shanghai, China.
authors.forename: Qing-Mao
authors.initials: QM
authors.lastname: Wang
authors.affiliation: Department of Minimally Invasive Surgery, Shishi Hospital, 362700 Shishi, Fujian Province China.
authors.forename: Zhao-Hui
authors.initials: ZH
authors.lastname: He
keywords: Hydronephrosis; Minimally invasive nephrolithotomy; Renal staghorn calculi; Types of calculus; Upper ureteral and renal calculi