V11-06: Step by Step Ultrasound-guided Percutaneous Nephrolithotomy: A Single Hospital Experience
Percutaneous nephrolithotomy is effective for patient who has large renal stone > 2cm in size. Ultrasound-guided percutaneous nephrolithotomy can be performed safely without radiation exposure. We describe how we performed ultrasound-guided percutaneous nephrolithotomy step by step according to our experience.
We conducted a retrospective study of patients received percutaneous nephrolithotomy from January 2012 to October 2016. In total, 205 patients were enrolled. One-hundred and thirty-six patients received ultrasonic-guide operation and 69 received fluroscopic-guided operation. Patients' clinical characteristics, operation time, hospital stay, complication, hematocrit and renal function data were recored and analyzed. We performed ultrasound-guided by following steps:(1) Double-J catheter insertion (2) Three-way Foley insertion (3) Normal saline instillation and Foley clumping (4) Needle puncture (5) Incision and Dilatation (6) Balloon dilatation and insert sheath.
Among two groups, the patient clinical characteristics do not have significant difference. There were also no difference during hospital stay, hematocrit and renal function change. However, shorter operation time (62mins vs. 87mins, p
ultrasound-guided percutaneous lithotomy is feasible for patient who has large renal stones. The outcome is similar compared to traditional fluroscopic-guided procedure. In our experience, ultrasound-guide may shorten puncture time and decrease the radiation exposure to patients and staffs. Double-J catheter insertion before puncture to create dilated calyces may help puncture easier.