A percutaneous nephrostomy tract was used as a conduit to the kidney and ureter for extraction of 149 calculi in 100 patients. A variety of grasping and fragmentation techniques under fluoroscopic and endoscopic control were used to extract calculi in 88% of the patients. With experience, operator efficiency and rate of stone extraction increased from 76% early in the series to 91% in the most recent patients, and the incidence of complications decreased from 17 to 5%. Percutaneous removal of upper tract urinary calculi appears to be an appropriate alternative to an open operation in most patients with symptomatic urolithiasis.
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