V11-06 STEP BY STEP ULTRASOUND-GUIDED PERCUTANEOUS NEPHROLITHOTOMY: A SINGLE HOSPITAL EXPERIENCE

Abstract

You have accessJournal of UrologyUrolithiasis1 Apr 2017V11-06 STEP BY STEP ULTRASOUND-GUIDED PERCUTANEOUS NEPHROLITHOTOMY: A SINGLE HOSPITAL EXPERIENCE Yite Chiang and Kaiyi Tzou Yite ChiangYite Chiang More articles by this author and Kaiyi TzouKaiyi Tzou More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2995AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES 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. METHODS 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. RESULTS 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< 0.05), was noted in ultrasound-guided group maybe due to shortened puncture time. In the other hand, complete stag-horn stone patients had higher stone free rate (75% vs 90%, p< 0.05) in fluroscopic group. Complication rate is similar in two groups but one patient in ultrasound-guided group had developed bladder rupture while normal saline instillation by pressure pump. CONCLUSIONS 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. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e1283 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Yite Chiang More articles by this author Kaiyi Tzou More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...