Stereotactic localisation system: a modified puncture technique for percutaneous nephrolithotomy.

ABSTRACT

The objective of the study was to establish and evaluate a modified puncture and dilation technique-"stereotaxic localisation" system-and the corresponding instruments for percutaneous nephrostomy. Four hundred patients were randomised to the intervention group (200 cases, stereotaxic location puncture and dilation procedures) and the traditional group (200 cases, traditional procedure) under X-ray guidance. In the modified intervention system, the distance and horizontal angle of the puncture pathway between the puncture point and the target site were calculated accurately. The time for punctures, time with X-ray exposure and operation, success rate of each puncture to access the target, number of patients requiring blood transfusion, stone clearance, drops of haemoglobin and days of hospital stay were compared between the two groups. In the traditional and intervention groups, the time for puncture was 17 and 7 min, respectively; the X-ray exposure time was 9.1 and 1.3 min; the cases requiring blood transfusion were 9 and 5; and the success rates for each puncture to access the target were 42.9 and 88.0%, all with statistical difference (p < 0.01). The other outcomes and complications revealed similar trends. The stereotaxic localisation system for puncture is statistically better than the traditional procedure used in this study. The stereotaxic localisation system in this study is safer and more accurate, and provides easier access to the target with less bleeding and reduced exposure to X-ray compared to the traditional puncture and dilation procedures of percutaneous nephrostomy.