Medical Science
Volume 24, Issue 104, July - August, 2020
Effective evaluation of using ultrasound-guided renal access for percutaneous nephrolithotomy
Pham Hong Đuc1, Tran Vinh Hung2, Hung Quang Huy3♦, Nguyen Thuy Linh1, Bui Van Giang1
1Radiology Department, Hanoi Medical University, Ha Noi, Vietnam
2Binh Dan Hospital, Ho Chi Minh City, Vietnam
3Radiology Department, Pham Ngoc Thach University of Medicine, Ho Chi Minh city, Vietnam
♦Corresponding author
Radiology Department, Pham Ngoc Thach University of Medicine, Ho Chi Minh city,
Vietnam
Email: huyhq@pnt.edu.vn
ABSTRACT
Purposes: To evaluate the effectiveness of using ultrasound-guided renal access for percutaneous nephrolithotomy (PCNL). Methods:
Between January 2016 and April 2017, at Saint Paul hospital, 130 patients were treated, 88 men and 42 women, with a mean age of
52.4 ± 11.5 years and a mean stone size of 30.82 11.47mm. All stones were located in the renal pelvis with mild to moderate
hydronephrosis seen on ultrasound or uroscanner. A ureteral catheter was inserted cystoscopically, and saline was injected for more localization of the pelvicalyceal system (PCS) if needed. Puncture of the PCS was performed with an 18-gauge nephrostomy needle
through the calyx, and all the stages, including dilatation, were performed under ultrasonography guidance. Results: Pyelocaliceal
access: 95% of the lower caliceal group, 5% of the middle caliceal group, no case in the upper caliceal group. The intervention time
was 12.4 ± 3.7minutes. The average number of punctures was 1.25 ± 32. There was a correlation between the number of punctures
and the patient's BMI with p = 0.016. Complications: 13 cases (10%) significant bleeding have to blood transfusions, 10 cases (7.7%)
postoperative fever, one case (0.8%) pseudo-aneurysm after seven days, and one case (0.8%) perirenal fluid collection. Conclusion:
ultrasound guidance for renal access and tract dilation in PCNL is a useful technique and fewer complications; however, more
experience is needed.
Keywords: percutaneous nephrolithotomy (PCNL), renal stones, sonography guidance
Medical Science, 2020, 24(104), 2195-2199
