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ObjectiveTo compare the therapeutic efficacy and safety of holmium laser lithotripsy and pneumatic lithotripsy for complex renal calculi with minimally invasive percutaneous nephrolithotomy.MethodsReview of September 2008 ~ December 2010 under the pressure of our hospital with minimally invasive percutaneous nephrolithotomy pneumatic or holmium laser lithotripsy in 80 patients with clinical data of patients with kidney stones, comparative analysis of two different methods of lithotripsy success rate, operative time, Postoperative hospital stay and surgical complications and other indicators.ResultsThe success rate of primary lithotripsy was 95.0%(38/40) in the cases received holmium laser, and 80.0%(32/40) in those who underwent pneumatic lithoclast;two groups was statistically significant (P <0.05). The average operation time of holmium laser lithotripsy was (134.5±31.2) min, the average operation time of pneumatic lithotripsy was (125.4±22.3) min, no significant difference between the two groups (P> 0.05). The average postoperative hospital stay of holmium laser lithotripsy was (7.3±2.0) d, the average postoperative hospital stay of pneumatic lithotripsy was (6.8±2.3) d, no significant difference between the two groups (P> 0.05). There were 8 patients with complications in holmium laser lithotripsy group, including fluid leakage in 1 case, 1 case of pelvic injury, bleeding in 4 cases, 2 cases of postoperative fever, the complication rate was 20.0% (8 / 40), the pneumatic lithotripsy group complications were 9 cases, including 2 cases of pelvic injury, bleeding in 3 cases, 3 cases of postoperative fever, pleural effusion in 1 case, the complication rate was 22.5% (9 / 40), no significant difference between the two groups (P> 0.05).ConclusionsThe holmium laser lithotripsy and pneumatic lithotripsy are all safe and effective methods in the treatment of complex renal calculi with minimally invasive percutaneous nephrolithotomy. Comparing the two, the holmium laser lithotripsy is higher in the success rate of primary lithotripsy, and can deal effectively with the narrow and calyceal stones, remove polyps and parcel of stones . Both operative time, postoperative hospital stay and complications are no significant differences. Our experience, the holmium laser lithotripsy is more worthy of application compared to the second-generation pneumatic lithotripsy.
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