[The clinical significance of 50 cases of percutaneous nephroureteral lithotripsy].

Percutaneous nephroureteral lithotripsy (PNL) was conducted in 50 patients with renal or ureteral calculi between March 2000 and August 2002. The mean age of patients was 56.6 years (range 25-82 years) and they included 29 males (58.0%) and 21 females (42.0%). The calculi were renal calculi in 38 patients (76.0%) and ureteral calculi in 12 patients (24.0%). The mean number of calculi was 1.5 (1-10 calculi, median number 1). The mean of the maximum calcule diameter was 30.9 mm (15.0-83.0 mm) for the renal calculi and 17.4 mm (8.0-27.0 mm for the ureteral calculi. The lithotripsy device was an ultrasonic lithotriptor (ALOKA) or Lithoclast (SWISS), as appropriate, and was used with a 24 Fr rigid endoscope (TAKEI). All operations were performed under lumbar spinal anesthesia. Eighteen of the 38 renal calculus patients were treated with PNL alone. In the other 19 PNL was combined with postoperative extracorporeal shock wave lithotripsy (ESWL). Seven of the 12 patients with ureteral calculi were treated with PNL alone, and 5 with PNL combined with postoperative ESWL. After 3 months, the treatment results were Tx(3)-0 in 45 patients (90.0%), and Tx(3)-2 in 5 patients (10.0%). The mean period of postoperative hospitalization was 30.3 days (10-86 days), with a median of 26 days. Complications were renal pelvis perforation in 1 patients and fever of 38.0 degrees C or above in 16 patients, but there was no hemorrhaging that required transfusion or other serious complications. PNL is a safe and reliable treatment method, and should be considered as a treatment option in cases of large calculi when a short treatment period is desired.