Objective:To discuss the safety and efficacy of percutaneous nephrolithotomy(PCNL) in high-risk patients.Methods: The records of 189 consecutive PCNL procedures performed on 178 patients from January 2008 to January 2010 were retrospective analyzed.The preoperative conditions of the patients were evaluated by American Society of Anesthesiologists(ASA) Scores.The patients were divided into a high-risk group(n=39)

which had an ASA score of III or IV

and a low-risk group(n=139) with scores of Ⅰ or Ⅱ.Results:42 procedures were performed in the high-risk group

and 147 procedures in the low-risk group.The low-risk group had a younger age than high-risk group(47.6 vs 55.2 y)(P<0.05).There was no difference observed in stone size and location.The mean number of comorbidities in high-risk group was 2.8

and 0.6 in low-risk group;the difference was significant(P<0.05).In the comparison of the intraoperative parameters

the general anesthesia time was longer in the high risk group(125.3 vs 102.4 min);no significant difference was observed in the estimated blood loss(128 vs 160 ml)(P>0.05).The overall complication rate had no difference between the high-risk(13.2%) and low-risk(10.8%)(P>0.05).The mean postoperative hospital stay was 7.6 d in the high-risk group and 4.8 d in the low-risk group respectively;the difference was significant(P<0.05).The stone-free rate in the high-risk group was 83%

and 94% in the low-risk group;the difference was significant(P<0.05).Conclusion:For the patients with high-risk preoperative conditions

PCNL can be a safe and effective procedure.