Feasibility of contrast-enhanced ultrasound and flank position during percutaneous nephrolithotomy in patients with no apparent hydronephrosis: a randomized controlled trial.
World J Urol
; 40(4): 1043-1048, 2022 Apr.
Article
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| MEDLINE
| ID: mdl-35061058
ABSTRACT
PURPOSE:
To investigate the puncture accuracy and feasibility of contrast-enhanced ultrasound (CEUS) guided percutaneous nephrolithotomy (PCNL) in flank position for patients with no apparent hydronephrosis.METHODS:
Between May 2018 and June 2020, 72 kidney stone patients with no or mild hydronephrosis were randomized into two groups a CEUS-guided PCNL group and a conventional ultrasound (US)-guided group. Patients' demographics and perioperative outcomes were compared, including the success rate of puncture via calyceal fornix, the success rate of a single-needle puncture, puncture time, operative time, postoperative hemoglobin loss, stone-free rate, incidence of complications and postoperative stay.RESULTS:
The success rate of puncture via calyceal fornix for CEUS-guided group was significantly higher than that for conventional US-guided group (86.1 vs. 47.2%, p = 0.002). Patients performed with CEUS-guided PCNL required shorter renal puncture time than those guided with conventional US (36.5 s vs. 61.0 s, p < 0.001). The median postoperative hemoglobin loss in the CEUS-guided group was significantly lower than that in conventional US-guided group (2.5 vs. 14.5 g/L, p < 0.01). There was no statistically significant difference in the success rate of a single-needle puncture, operative time, stone-free rate, incidence of complications and postoperative stay between the two groups.CONCLUSION:
CEUS guidance facilitates identification of the renal calyx fornix, and benefits more precise renal puncture and less hemoglobin loss in PCNL. CEUS-guided PCNL in flank position is a feasible approach to the treatment of kidney stone patients with no apparent hydronephrosis. TRIAL REGISTRATION NUMBER ChiCTR1800015417.Palabras clave
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Banco de datos:
MEDLINE
Asunto principal:
Nefrostomía Percutánea
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Cálculos Renales
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Nefrolitotomía Percutánea
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Hidronefrosis
Tipo de estudio:
Clinical_trials
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Guideline
Límite:
Humans
Idioma:
En
Año:
2022
Tipo del documento:
Article