The clinical efficacy in decreasing hemorrhagic complication by B-ultrasound combined with color Doppler ultrasound guidance in percutaneous nephrolithotomy

Abstract

Objective To evaluate the clinical significance of using B-ultrasound combined with color Doppler ultrasonography guidance in percutaneous nephrolithotomy (PCNL) to decease the incidence of hemorrhagic complication. Methods A total of 323 patients with renal or urethral stones who had undergone PCNL were retrospectively categorized into 2 groups. Group 1 (147 patients) underwent PCNL with single B-ultrasound guidance while group 2 (176 patients) underwent PCNL with combined B-ultrasound and color Doppler ultrasound guidance. The clinical characteristics and complications, especially hemorrhagic complications in the two groups were recorded and compared. Results There were no statistical significances in age [(53.2±12.9 ) years vs. (54.7±9.1 ) years], hight [(165.1±8.5) cm vs. (164.6±6.9) cm], weight[ (66.1±19.2) kg vs. (64.9±16.3) kg], stone burden [(680.5±56.4) mm2 vs.(654.0±76.9) mm2], operative time[(117.6±55.1) min vs. (121.4±54.3) min], stone-free rate (90.7% vs. 91.3%), or postoperative hospital stay [(4.9±2.2)d vs.( 4.7±1.7 )d] between the two groups. In the B-ultrasound combined color Doppler ultrasound guidance group, the rate of blood transfusion (1.1% vs.3.4%) and super-selective embolization (0 vs.3.4%) was significantly lower than that of the single B-ultrasound guidance group. Besides, the incidents of renal arteriovenous fistula (0 vs. 2.0%), pseudoaneurysm (0 vs. 2.0%), and perirenal hematoma (0 vs. 1.4%) were significantly lower in the B-ultrasound combined color Doppler ultrasound guidance group than that of the single B-ultrasound guidance group. Conclusion Using B-ultrasound combined color Doppler ultrasound guidance during PCNL resulted in the real-time detection and avoidance of the renal blood vessels during puncture and decreased the incidence of hemorrhagic complications. Key words: B-ultrasound combined with color Doppler ultrasound guidance; Percutaneous nephrolithotomy; Urinary calculi; Hemorrhagic complications