Computer tomography urography assisted real-time ultrasound-guided percutaneous nephrolithotomy on renal calculus

Abstract

This study aimed to assess the role of pre-designed route on computer tomography urography (CTU) in the ultrasound-guided percutaneous nephrolithotomy (PCNL) for renal calculus.From August 2013 to May 2016, a total of 100 patients diagnosed with complex renal calculus in our hospital were randomly divided into CTU group and control group (without CTU assistance). CTU was used to design a rational route for puncturing in CTU group. Ultrasound was used in both groups to establish a working trace in the operation areas. Patients’ perioperative parameters and postoperative complications were recorded.All operations were successfully performed, without transferring to open surgery. Time of channel establishment in CTU group (6.5 ± 4.3 minutes) was shorter than the control group (10.0 ± 6.7 minutes) (P = .002). In addition, there was shorter operation time, lower rates of blood transfusion, secondary operation, and less establishing channels. The incidence of postoperative complications including residual stones, sepsis, severe hemorrhage, and perirenal hematoma was lower in CTU group than in control group.Pre-designing puncture route on CTU images would improve the puncturing accuracy, lessen establishing channels as well as improve the security in the ultrasound-guided PCNL for complex renal calculus, but at the cost of increased radiation exposure.

Safety of Minimally Invasive Percutaneous Nephrolithotmy in High Risk Patients in Lateral Position - A Single Center Study

“…In the patients with high BMI and severe IHD, there are high risks for developing hemodynamic instability and difficult ventilation in prone position during mini PCNL and with the advent of newer techniques in endourology open surgery seems very unrealistic unless it is the last resort. 20,21 We found lateral decubitus position ideal for PCNL in such patients where cardiopulmonary stress is thought to be poorly tolerated. It is the most convenient position in cases with severe kyphosis, when prone or supine positions are not an option as demonstrated by Gofrit et al, 22 and other researchers.…”

Application of a novel computer-assisted surgery system in percutaneous nephrolithotomy: A controlled study

“…Traditional studies tended to perform preoperative planning with 2D CT images[ 18 ]. It was difficult to display overall 3D views in the simulation processes and the 3D precise measurements of each parameter.…”

Real-Time Ultrasound-Guided Percutaneous Nephrolithotomy Using Newly Developed Wireless Portable Ultrasound: A Single-Center Experience

“…The probe was used to scan the approximate puncturing area on the back, which was designed on CT urography before surgery. 8 The urologist observed real-time ultrasonic images displayed on the intelligent terminal to find the target kidney calyx. And then an 18-G coaxial needle was inserted into the target calyx under the guidance of the wireless portable ultrasound (Figure 2).…”