Relative factors analysis of residual stones after stageⅠpercutaneous nep-hrolithotomy
WANG Pengxin1,2 WANG Xing3 TIAN Fei2 MA Li2 ZHANG Di4 DING Yuzhi5
1.Xinxiang Medical University, He′nan Province, Xinxiang 453003, China;
2.Department of Urology, the People′s Hospital of Dingzhou City, Hebei Province, Dingzhou 073000, China;
3.Department of Thoracic Surgery, the People′s Hospital of Dingzhou City , Hebei Province, Dingzhou 073000, China;
4.Department of Anesthesiology, the People′s Hospital of Dingzhou City, Hebei Province, Dingzhou 073000, China;
5.Department of Hematheology, the People′s Hospital of Dingzhou City, Hebei Province, Dingzhou 073000, China
Abstract:Objective To investigate the main influencing factors of residual stones after stageⅠ percutaneous nephrolithotomy (PCNL). Methods The perioperative data of 475 patients with unilateral renal calculi treated with PCNL in the urology department of Dingzhou People′s Hospital of Hebei Province from April 2013 to October 2017 were retrospectively analyzed. Patients with residual stones after operation were classified into the group of residual stones (group A), a total of 103 cases; the data of patients with no residual stones and clinically significant residual stones were classified into the control group (group B), a total of 372 cases. Univariate analysis was performed on factors that may affect the residual stones after stage Ⅰ PCNL, and statistically significant factors were analyzed by multivariate Logisitic regression. Results The incidence of residual calculi after stage Ⅰ PNCL was 21.68%. The type of renal pelvis, stone load, staghorn calculi, renal insufficiency, operative pathway and bleeding volume were independent risk factors for residual calculi after stage Ⅰ PCNL (P < 0.05). Conclusion Stone load > 1000 mm2, branched pelvis, staghorn calculi, renal insufficiency, single channel, and bleeding volume > 200 mL can increase the risk of residual calculi after stage Ⅰ PCNL. Preoperative correct assessment of the type of renal pelvis, active improvement of renal function, individualized treatment for staghorn calculi or complex renal calculi with excessive stones load, and active reduction of intraoperative bleeding can effectively reduce the risk of residual stones after stage Ⅰ PCNL.