Ultra-mini percutaneous nephrolithotomy guided by B-ultrasonography in the treatment of kidney stones

Abstract

Objective To evaluate the safety and efficacy of ultra-mini percutaneous nephrolithotomy (UMP) guided by B-ultrasonography in the treatment of kidney stones. Methods The data of 43 patients diagnosed as kidney stones were retrospectively reviewed, who underwent the UMP from June 2015 to January 2017.There were 6 cases with renal upper calyx stones, 8 cases with renal middle calyx stones, 22 cases with inferior calyx stones, 7 cases with renal pelvis stones.In this cohort, no hydronephrosis in 12 cases, 21 cases of moderate hydronephrosis, 10 cases of milddle hydronephrosis, and 8 cases of residual stones after extracorporeal shock wave lithotripsy(ESWL) or retrograde intra renal surgery(RIRS) were found.The mean stone size was (17.0±7.6)mm(ranging from 10 to 32 mm). The mean CT value was(1054.0±208.7)HU(ranging from 303 to 1640 HU). Results All patients were treated by single tract UMP.The mean operating time was(63.3±19.8)min (ranging from 25 to 132 min). The mean postoperative hospital stay was(3.5±1.4)days (ranging from 3 to 6 days). The usage rate of pain medication was 11.6%(5/43). The stone free rate was 81.4%(35/43) and 93.0%(40/43)on the first day and the first month after the operation, respectively. Nephrostomy tube and Double-pigtail stent were not placed at the end of operation. No serious compliclions were observed. Conclusions UMP can be a safe and effective method for the treatment of kidney stores, especially for inferior calyceal stones less than 2.5 cm. It offers high stone clearance rate, small trauma, fewer complications, rapid recovery, minimally invasiveness, short length of hospital stay and improved quality of life. Key words: Kidney Calculi; Nephrostomy, Percutaneous; Ultrasonography