Results of treatment of renal stones by percutaneous nephrolithotomy, based on a series of 115 cases.

Objectives : The objective of this study was to analyse the results of perc utaneous nephrolithotomy (PCNL), which was recently introduced into Tunisia , in order to determine its place among the treatment options for renal sto nes. Material and Methods : Our retrospective study was based on 115 consecutive PCNL procedures performed between April 1994 and November 1997. The stone was a single pelvic stone bt 13 cases, lower caliceal in 15 cases , lower pyelocaliceal in 28 cases, partial staghorn in 20 cases, total stag horn in 16 cases and multiple pyelocaliceal in 23 cases, In our series, ultrasound lithotripsy constitutes the procedure of choice f or renal stone fragmentation. Results : A good result was obtained immediately irt 67% of cases. This fig ure is lower than that published in the literature because of the complexit y of the stones a,td the high failure rate due to the learning curve, invol ving 6 members of the team. In the case of failure, the procedure was converted to conventional surgery under the same anaesthetic in 20 patients. Residual stories, observed in 23 patients, were successfully treated by ext racorporeal shock-wave lithotripsy (ESWL) in 79% of cases. By combining PCNL and ESWL, the good result rate was 80%. The mortality rate of this series was 0.8% and the morbidity rate was 7.5%. Complications were generally rare and often minor. Conclusion : PCNL occupies an important place in the treatment of renal sto ries, The results depend on the site, size and number of stories and on the operator's experience.