Abstract: Objective To explore the therapeutic effect of extracorporeal shock wave lithotripsy on renal calculi and the influencing factors of surgical failure. Methods A retrospective analysis was performed on 600 outpatients and inpatients with kidney stones admitted to our hospital from May 2016 to May 2022. All patients received extracorporeal shock wave lithotripsy and success rate was calculated. The observation group （n=476） and the control group （n=124） were divided according to whether the surgery was successful or not. The general data and the operation conditions of patients in the two groups were compared, and the independent factors affecting the failure of extracorporeal shock wave lithotripsy were analyzed. Results The success rate of primary lithotripsy was 79.33% in the 600 patients. The complication rate was 2.33%, and all patients improved significantly after anti-infection treatment. There was no significant difference between the two groups in terms of gender, age, history of stone surgery, average disease duration, hematuria, pain, hydronephrosis, and other clinical symptoms （P>0.05）; there was a significant difference between the two groups in terms of body mass index （BMI）, stone size, stone location, surgical position, number of impacts, and operator's working years （P<0.05）; there was no significant difference between the two groups in terms of surgical area and lithotripsy voltage （P>0.05）. The results of regression analysis showed that surgical position, stone size, and number of impacts were independent risk factors for failure of extracorporeal shock wave lithotripsy for kidney stone treatment （P<0.05）. Conclusion The success rate of extracorporeal shock wave lithotripsy for renal calculi is 79.33%, and it is safe. The factors associated with the failure of extracorporeal shock wave lithotripsy for renal calculi mainly include the surgical position, the size of the calculi, and the number of shocks. Therefore, clinically, patients with large stones should try to adopt supine position, and increase the number of shocks while ensuring the safety of patients, so as to further improve the success rate of extracorporeal shock wave lithotripsy.

Key words: Extracorporeal shock wave lithotripsy, Renal calculus, Treatment effect, Lithotripsy failure, Influencing factors, Stone size