Efficacy of zero-pressure percutaneous nephrolithotomy combined with hands-free pneumatic lithotripsy in the one-stage treatment of calculous pyonephrosis
Objective To evaluate the efficacy and safety of zero-pressure percutaneous nephrolithotomy(PCNL)combined with hands-free pneumatic lithotripsy in the one-stage treatment of calculous pyonephrosis in the non-acute infection phase.Methods Clinical data of 15 patients'treated during Feb.2022 and Dec.2023 were retrospectively analyzed.Double-sheath negative pressure PCNL was adopted,with zero-pressure gravity perfusion where the perfusion height was at the level of the patients'kidney,not exceeding 20 cm above the kidney.Pneumatic lithotripsy was performed without the need to hold the device with hand.Results The median stone diameter was 28(range 22-40)mm,with a median stone density of 1028(range 765-1305)Hu.All operations were successful.The median operation time was 55(range 35-90)min.Postoperative low fever(Clavien grade Ⅰ)occurred in 1 case,and high fever(Clavien grade Ⅱ)occurred in 1 case,with no complications of Clavien grade Ⅲ or above.The initial stone-free rate was 73.3％,and the stone-free rate after one month was 93.3％.Conclusion For patients with calculous pyonephrosis in the non-acute infection phase,one-stage treatment using zero-pressure PCNL combined with hands-free pneumatic lithotripsy demonstrates good efficacy and safety.
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