, Volume 42, Issue 2, pp 165–169 | Cite as

Multiple tracts percutaneous nephrolithotomy assisted by LithoClast master in one session for staghorn calculi: report of 117 cases

Original Paper


The objective of the study is to evaluate the safety, efficacy and outcome of multiple tracts percutaneous nephrolithotomy (PCNL) assisted by LithoClast master (the third-generation Electro Medical System) in one session for the treatment of staghorn calculi. From October 2011 to March 2013, 117 patients with staghorn calculi underwent multiple tracts PCNL in our hospital. The combined pneumatic and ultrasonic powered lithotripter (EMS LithoClast master) was used to fragment and remove the calculi. The data were retrospectively analyzed with regard to stone burden, number of tracts, operation time, total operative blood loss, postoperative hospital stay, complications rate, and stone clearance rate. A total of 142 renal units in 117 patients (63 men and 54 women) were treated. Of the 142 renal units, 77 (54.2 %) had complete staghorn calculi, and 65 (45.8 %) had partial staghorn calculi. A total of 416 tracts were established in the 142 renal units. The mean number of tracts used in a single renal unit was 2.8 (range 2–4), most required three tracts. The mean (range) operating time is 72 (55–130) min. The mean (range) duration of postoperative hospital stay is 5.5 (3–9) days. Mean estimated operative blood loss is 150 (60–350) mL. The complications included blood transfusion in 9 (7.7 %) patients, high fever in 12 (10.3 %), sepsis in 5 (4.3 %), hydrothorax in 4 (3.4 %), and pseudoaneurysm in 3 (2.6 %). A complete stone clearance rate of 87.2 % (102/117) was achieved after one session of PCNL. This rate increased to 94.0 % after a secondlook procedure. In conclusion, multiple tracts PCNL assisted by EMS LithoClast master in one session is safe and effective in achieving a great stone clearance rate with acceptable morbidity for the treatment of staghorn calculi.


Multiple tracts Percutaneous nephrolithotomy LithoClast master Staghorn calculi 


Conflict of interest



  1. 1.
    Ganpule AP, Desai M (2008) Management of the staghorn calculus: multiple tract versus single-tract percutaneous nephrolithotomy. Curr Opin Urol 18(2):220–223PubMedCrossRefGoogle Scholar
  2. 2.
    Preminger GM, Assimos DG, Lingeman JE et al (2005) AUA GUIDELINE on management of staghorn calculi: diagnosis and treatment recommendations. J Urol 173(6):1991–2000PubMedCrossRefGoogle Scholar
  3. 3.
    Hegarty NJ, Desai MM (2006) Percutaneous nephrolithotomy requiring multiple tracts: comparison of morbidity with single-tract procedures. J Endourol 20(10):753–760PubMedCrossRefGoogle Scholar
  4. 4.
    Aron M, Yadav R, Goel R et al (2005) Multi-tract percutaneous nephrolithotomy for large complete staghorn calculi. Urol Int 75(4):327–332PubMedCrossRefGoogle Scholar
  5. 5.
    Liatsikos EN, Kapoor R, Lee B et al (2005) “Angular percutaneous renal access” multiple tracts through a single incision for staghorn calculous treatment in a single session. Eur Urol 48(5):832–837PubMedCrossRefGoogle Scholar
  6. 6.
    Cho HJ, Lee JY, Kim SW et al (2012) Percutaneous nephrolithotomy for complex renal calculi: is multi-tract approach ok? Can J Urol 19(4):6360–6365PubMedGoogle Scholar
  7. 7.
    Alken P, Hutschenreiter G, Guenther R (1982) Percutaneous kidney stone removal. Eur Urol 8(5):304–311PubMedGoogle Scholar
  8. 8.
    Segura JW, Patterson DE, LeRoy AJ et al (1985) Percutaneous removal of kidney stones: review of 1,000 cases. J Urol 134(6):1077–1081PubMedGoogle Scholar
  9. 9.
    Clayman RV, Surya V, Miller RP et al (1983) Percutaneous nephrolithotomy; an approach to branched and staghorn renal calculi. JAMA 250(1):73–75PubMedCrossRefGoogle Scholar
  10. 10.
    Adams GW, Oke EJ, Dunnick NR et al (1985) Percutaneous lithotripsy of staghorn calculi. AJR Am J Roentgenol 145(4):803–807PubMedCrossRefGoogle Scholar
  11. 11.
    Kerlan RK Jr, Kahn RK, Laberge JM et al (1985) Percutaneous removal of renal staghorn calculi. AJR Am J Roentgenol 145(4):797–801PubMedCrossRefGoogle Scholar
  12. 12.
    Netto NR Jr, Ikonomidis J, Ikari O et al (2005) Comparative study of percutaneous access for staghorn calculi. Urology 65(4):659–662PubMedCrossRefGoogle Scholar
  13. 13.
    Jackman SV, Hedican SP, Peters CA et al (1998) Percutaneous nephrolithotomy in infants and preschool age children: experience with a new technique. Urology 52(4):697–701PubMedCrossRefGoogle Scholar
  14. 14.
    Lahme S, Bichler KH, Strohmaier WL et al (2001) Minimally invasive PCNL in patients with renal pelvic and calyceal stones. Eur Urol 40(6):619–624PubMedCrossRefGoogle Scholar
  15. 15.
    Zhong W, Zeng G, Wu W et al (2011) Minimally invasive percutaneous nephrolithotomy with multiple mini tracts in a single session in treating staghorn calculi. Urol Res 39(2):117–122PubMedCrossRefGoogle Scholar
  16. 16.
    Hofmann R, Weyer J, Heidenreich A et al (2002) Experimental studies and first clinical experience with a new Lithoclast and ultrasound combination for lithotripsy. Eur Urol 42(4):376–381PubMedCrossRefGoogle Scholar
  17. 17.
    Auge YK, Lallas CD, Pietrow PK et al (2002) In vitro comparison of standard ultrasound and pneumatic lithotrites with a new combination intracorporal lithotripsy device. Urology 60(1):28–32PubMedCrossRefGoogle Scholar
  18. 18.
    Wang J, Zhou DQ, He M et al (2013) One-phase treatment for calculous pyonephrosis by percutaneous nephrolithotomy assisted by EMS LithoClast master. Chin Med J 126(8):1584–1586PubMedGoogle Scholar
  19. 19.
    Stoller ML, Wolf JS Jr, St Lezin MA (1994) Estimated blood loss and transfusion rates associated with percutaneous nephrolithotomy. J Urol 152(6 Pt 1):1982–1983Google Scholar
  20. 20.
    Singla M, Srivastava A, Kapoor R et al (2008) Aggressive approach to staghorn calculi: safety and efficacy of multiple tracts percutaneous nephrolithotomy. Urology 71(6):1039–1042PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Jinbo Chen
    • 1
  • Xu Zhou
    • 1
  • Zhi Chen
    • 1
  • Longfei Liu
    • 1
  • Li Jiang
    • 1
  • Cheng Chen
    • 1
  • Lin Qi
    • 1
  • Xiongbing Zu
    • 1
  • Hequn Chen
    • 1
  1. 1.Department of Urology, Xiangya HospitalCentral South UniversityChangshaChina

Personalised recommendations