الفهرس 
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Abstract
In recent years, PCNL has become the treatment of choice for patients with renal calculi larger than 2 cm in diameter. Proper establishment of the percutaneous tract is the most important step in percutaneous stone removal. If appropriately done the efficacy is optimal, with low complication rates.
The use of warmed pressurized irrigation fluid during PCNL has certain advantages, such as lack of postoperative hypothermia and better visualization with subsequent shorter operative time.
This study was done in Urology Department of the Cleveland clinic from December 2013 to May 2015. A total of ninety patients with renal calculi treated by percutaneous nephrolithotomy were included in this study. Forty four patients were treated by low pressure irrigation fluid and the other forty six patients were treated by high pressure irrigation fluid.
Our result shown that SIRS occurred in 21(46%) patients in the higher pressure group (>200mmHg) compared to 5 (11%) of the low pressure group (<80mmHg) (p=0.0002). Also using a warm irrigation fluid (35 ºC) has shown statistically significant decrease in the incidence of hypothermia by the end of surgery (p=0.002) with difference between the initial and final core body temperatures = 0.9±0.5 °C in cold group and 0.5±0.4°C in warm group (p=0.001).
from our study, we can conclude that the use of high irrigation pressure increases the risk of systemic inflammatory response syndrome postoperatively. So, consideration should be given to minimizing irrigation pressures, particularly in high risk patients.