Assessment of the Contrast-Enhanced Ultrasound in Percutaneous Nephrolithotomy for the Treatment of Patients with Nondilated Collecting System

Guo, Xiong; Zhang, Zhi; Liu, Zonglai; Fu, Haibo; Gao, Xiaozhan; Yang, Han; Gao, Pan; Li, Xinyu; Ai, Wei; He, Ziqiu; Du, Dan

doi:10.1089/end.2020.0564

Cited by 7 publications

(14 citation statements)

References 24 publications

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“…Chi et al first introduced CEUS to aid US-guided PCNL in five patients without hydronephrosis, via retrograde ultrasound contrast injection to improve the visibility of the collecting system, and achieved high puncture success rate up to 100% [7]. Guo and colleagues demonstrated that compared to conventional US-guided PCNL, CEUS-guided PCNL achieved higher successful rate of one puncture, shorter puncture time and lower postoperative hemoglobin loss [8]. Subsequently, Xia and coworkers conducted a prospective, randomized trial in 154 kidney stone patients with nondilated collecting system, to investigated the efficacy and safety of CEUS-guided PCNL [21].…”

Section: Discussionmentioning

confidence: 99%

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Feasibility of contrast-enhanced ultrasound and flank position during percutaneous nephrolithotomy in patients with no apparent hydronephrosis: a randomized controlled trial

et al. 2022

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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.

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Section: Discussionmentioning

confidence: 99%

“…Previous studies have shown that intraoperative use of contrast-enhanced ultrasound (CEUS) in the prone position can achieve better visibility of nondilated collecting systems and facilitate more accurate puncture [7,8]. However, the puncture accuracy and safety of CEUS-guided PCNL in flank position has not been investigated so far.…”

Section: Introductionmentioning

confidence: 99%

Feasibility of contrast-enhanced ultrasound and flank position during percutaneous nephrolithotomy in patients with no apparent hydronephrosis: a randomized controlled trial

et al. 2022

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“…The conclusions were similar, with statistically significant better outcomes for the CEUS group concerning the rate of single-needle puncture (88.5 vs. 73.7%), the number of needle passes (1.17 vs. 1.45), the puncture time (29.2 vs. 47.9 s) and the haemoglobin loss (10.4 vs. 15.3 mg/dl). Operation time and SFR were also similar between the two groups, but differently from the study of Guo et al [25], the complications did not differ between the two techniques [24 & ]. In addition to the standard supine and prone positions, the efficacy of the CEUS-guided puncture was also evaluated in the flank position by Liu et al [26].…”

Section: Contrast-enhanced Ultrasonography Guided Puncturementioning

confidence: 62%

“…It is relatively cheap and with good stability, facilitating the discrimination between a dilated calyx and a renal cyst. The successful access to the collecting system becomes obvious, as the contrast flows out of the needle [25].…”

Section: Contrast-enhanced Ultrasonography Guided Puncturementioning

confidence: 99%

Advances in percutaneous renal puncture: a comprehensive review of the literature

Tatanis

Cracco²,

Liatsikos

2022

Current Opinion in Urology

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Purpose of reviewPercutaneous nephrolithotomy (PCNL) constitutes the gold standard procedure for patients suffering from more than 2 cm renal stones. The puncture is a very critical step of PCNL, affecting manoeuvrability of the nephroscope, possibility to remove stone fragments, risk of bleeding and radiation exposure. The aim of the current review was to discuss the advances in percutaneous renal puncture. Recent findingsFollowing technological evolution in medicine, there was a consistent development in the puncture techniques, aiming at the improvement of its efficacy and safety. The use of specific agents can improve ultrasonic guidance, making the challenging step of gaining access to the kidney easier for the experienced surgeon and more accessible for the resident urologist. Future developments in the electromagnetic and three-dimensional (3D) technology may establish a high level of accuracy with decreased rates of related complications, even in the hands of beginners.

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“…According to a single-centre retrospective investigation conducted by Liu et al [ 7 ], contrast-enhanced US-assisted PCNL is beneficial for patients with a nondilated renal collecting system, and is accompanied by a high success rate and tolerable sequelae. Recent investigations have been compared contrast-enhanced ultrasound with traditional ultrasound-guided PCNL [ 8 – 11 ]. We performed this meta-analysis to assess the effectiveness and security of these two various surgically assisted ultrasound-guided techniques.…”

Section: Introductionmentioning

confidence: 99%

Contrast-enhanced ultrasound versus conventional ultrasound-guided percutaneous nephrolithotomy in patients with a non-dilated collecting system: results of a pooled analysis of randomized controlled trials

Wang

Yin

et al. 2023

BMC Urol

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Background Contrast-enhanced ultrasound in percutaneous nephrolithotomy (CEUS-PCNL) is an economical and practical technique for the treatment of patients with renal stones without significant collecting system dilatation. The aim of this systematic review is to compare the safety and efficacy of CEUS-PCNL and conventional ultrasound (US)-guided (US-PCNL) treatment of patients with renal calculi without significant hydronephrosis. Methods This review was conducted with strict adherence to the PRISMA guidelines. Comparative studies on CEUS-PCNL and US-PCNL published in PubMed, SinoMed, Google Scholar, Embase, and Web of science until March 1, 2023, were systematically searched. RevMan 5.1 software was used for meta-analysis. Pooled odds ratios (ORs), weight mean differences (WMDs) and standard mean differences (SMDs) with 95% confidence intervals (CIs) were calculated using the fixed-effects or random-effects model. Publication bias was evaluated using funnel plots. Results Four randomized controlled trials involving 334 patients (168 with CEUS-guided PCNL and 166 with US-guided PCNL) were identified. There was no statistically significant difference between CEUS-guided PCNL and US-guided PCNL in terms of the operation time (SMD: − 0.14; 95% CI − 0.35 to 0.08; p = 0.21), minor complications (p = 0.48), major complications (p = 0.28) and overall complications (p = 0.25). However, CEUS-guided PCNL had a higher stone-free rate (OR: 2.22; 95% CI 1.2 to 4.12; p = 0.01), higher success rate of single-needle punctures (OR:3.29; 95% CI 1.82 to 5.95; p < 0.0001), shorter puncture time (SMD: − 1.35; 95% CI − 1.9 to − 0.79; p < 0.00001), shorter hospital stay (SMD: − 0.34; 95% CI − 0.55 to − 0.12; p = 0.002) and lesser hemoglobin loss (SMD: − 0.83; 95% CI − 1.06 to − 0.61; p < 0.00001) as compared with conventional US-guided PCNL. Conclusions According to almost all pooled data, CEUS-guided PCNL is superior to US-guided PCNL in terms of the perioperative outcomes. However, many rigorous clinical randomized controlled studies are required to obtain more accurate results. Registration The study protocol was registered with PROSPERO (CRD42022367060).

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Assessment of the Contrast-Enhanced Ultrasound in Percutaneous Nephrolithotomy for the Treatment of Patients with Nondilated Collecting System

Cited by 7 publications

References 24 publications

Feasibility of contrast-enhanced ultrasound and flank position during percutaneous nephrolithotomy in patients with no apparent hydronephrosis: a randomized controlled trial

Feasibility of contrast-enhanced ultrasound and flank position during percutaneous nephrolithotomy in patients with no apparent hydronephrosis: a randomized controlled trial

Advances in percutaneous renal puncture: a comprehensive review of the literature

Contrast-enhanced ultrasound versus conventional ultrasound-guided percutaneous nephrolithotomy in patients with a non-dilated collecting system: results of a pooled analysis of randomized controlled trials

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