[Clinical experiences in 210 percutaneous removal of kidney and ureteral calculi]

The introduction of percutaneous nephrolithotomy and ureterolithotomy has greatly widened the therapeutical spectrum of urolithiasis. In this paper indications and contraindications of percutaneous stone removal will be discussed as well as techniques of this procedure. 210 percutaneous stone operations were performed after an initial training period primarily using local anesthesia (neuroleptanalgesia). This operative procedure allowed stone removal in patients otherwise inoperable because of increased operation risk or of advanced age. With increasing experience the success rate has been improved, though the stage of difficulties in nephrolithotomy and ureterolithotomy has increased too. Percutaneous operation primarily in connection with extracorporal shock wave lithotripsy is the first treatment modality for patients with staghorn stones. Possible complications (bleeding, perforation, injury to neighbouring organs) and their treatment are discussed.