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Background: Infectious staghorn renal stones are usually treated with one-phase for percutaneous puncture and drainage, and then two-phase for percutaneous nephrolithotomy (PCNL). The objective of the study was to evaluate the efficacy and safety of PCNL assisted by LithoClast master (the fifth-generation Electro Medical Systems, EMS) in one-phase treatment for staghorn renal stones with refractory infections.Methods: From September 2017 to September 2019, 80 patients with staghorn renal stones who underwent one-phase for PCNL combined with the fifth-generation EMS in our hospital were retrospectively analyzed. According to whether patients with staghorn renal stones were complicated with refractory infections or not before operation, they were divided into A group (48 cases with refractory infections) and B group (32 cases without infections). In A group, refractory infections were properly controlled with sensitive antibiotics before operation. The efficacy and safety of treatment for two groups were compared.Results: Before taking sensitive antibiotics in A group, there was statistical difference in the location of stones between the two groups (P＜0.05), while there were no statistical significances in other general clinical data between the two groups (P＞0.05). Although there were statistical differences in the increase rate of white blood cell count, C-reactive protein, procalcitonin on the first day after operation between the two groups (P＜0.05), there were no statistical differences in operation time, hospitalization time, hemoglobin, stone-free rate, Clavien-Dindo grade I complications, Clavien-Dindo grade II and above complications between the two groups (P＞0.05). Conclusions: For staghorn renal stones with refractory infections, based on the application of sensitive antibiotics before operation to properly control refractory infections, PCNL assisted by the fifth-generation EMS in one-phase can efficiently remove staghorn renal stones, without increasing the risk of postoperative complications. In the medical center with mature technical conditions and rich experience, staghorn renal stones with refractory infections can be selected carefully to carry out one-phase operation. |
