Ultrasonography combined with fluoroscopy for percutaneous nephrolithotomy: an analysis based on seven years single...

To assess the efficacy and safety of percutaneous nephrolithotomy (PCNL) under the guidance of ultrasonography and fluoroscopy.

We retrospectively analyzed 562 renal calculi patients (313 men and 249 women; mean age 46 years, ranged from 13 to 70 years) who underwent 582 PCNL from March 2004 to October 2011 in our department.

Of participants, 89.6% experienced less than 3 puncture times; 2 patients (0.4%) experienced puncture failures; percentage of single or multiple tracts was 89.7% and 10.3%, respectively, 55 patients (9.5%) needed auxiliary measures after one PCNL (24 second PCNL and 31 extracorporeal shock wave lithotripsy). The mean operative time was 82.3 min (range, 45-190 min). The stone free rate was 90.5%. Thirty five patients (6.0%) had postoperative fever and responded to antibiotics. Three patients (0.5%) developed pleural effusion and recovered after closed drainage of thoracic cavity. Thirteen patients (2.2%) needed blood transfusion. Twelve patients (2.1%) developed septic shock and were given anti-shock therapy. Two patients (0.3%) needed angiographic renal embolization or nephrectomy.

With its high success rate for achieving access to the targeted calyx and high stone clearance rate, the guidance of ultrasonography and fluoroscopy should be the first option in PCNL.