Efficacy and safety of percutaneous nephrolithotomy for stones in upper urinary tract with different composition

Objective:To compare the efficacy and safety of percutaneous nephrolithotomy(PCNL) for stones in upper urinary tract with different composition.Method:The clinical data of 190 patients underwent PCNL between April 2009 and November 2010 were retrospectively reviewed.According to the postoperative stone composition analysis result,the patients were divided into 3 groups(oxalate salt group,uric acid salt group and phosphate salt group).Stone burden,surgical time,stone free rate,change of hemoglobin level in peripheral blood and fever were compared with the three groups.Result:The stone volume was10.07±25.60 cm3(mean±standard deviation) in oxalate group,10.91±11.38cm3 in uric acid salt group and 19.19±56.16cm3 in phosphate salt group,P=0.584.The stone free rate was 75.0% in oxalate group,68.3% in uric acid salt group and 63.3% in phosphate salt group,P=0.316.The operative time was(76.2±38.9) minutes in oxalate group,(90.4±46.8) minutes in uric acid salt group and(76.6±37.0) minutes in phosphate salt group,P=0.155.Thirty patients got fever after operation in oxalate group,15 patients in uric acid salt group,17 patients in phosphate salt group,P=0.740.The perioperative hemoglobin level change was(12.6±11.1) g/L in oxalate group,(12.2±11.2) g/L in uric acid salt group,and(10.2±12.1) g/L in phosphate salt group,P=0.469.There were 4,1 and 5 patients received blood transfusion respectively.Conclusion:The efficacy and safety of precutaneous nephrolithotomy for oxalate salt stone,uric acid salt stone and phosphate salt stone were similar.